Baba Akira, Hamada Hidemichi, Kocha Hiroki
Department of Neuropsychiatry, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan.
Psychopathology. 2003 Mar-Apr;36(2):104-10. doi: 10.1159/000070366.
The musical hallucinations reported by 33 schizophrenics who fulfilled ICD-10 diagnostic criteria were assessed semiologically. The subjects were 24 men and 9 women. The duration of 48 episodes of musical hallucinations varied. They occurred at all times during the course of schizophrenia, and 9 of them (18.8%) occurred before the diagnosis was made. All of the episodes could be divided into three stages: 17 (35.4%) were first stage, close to obsession, 5 (10.4%) were second stage, close to Schneiderian first-rank symptoms, and 26 (54.2%) were third stage, which is the autochthonous experience. The sounds were in a subjective space in 38 episodes and in the majority of cases, their content was familiar. The second stage was associated with xenopathic experience ("gemachtes Erlebnis") and audition of thought, and words were added to melodies that normally had no lyrics. Musical hallucinations in schizophrenia are pseudohallucinations that originate in memory representations, and they may undergo a transition to true hallucinations. The authors think that the three stages are related to the severity of the disease.
对33名符合ICD - 10诊断标准的精神分裂症患者报告的音乐幻觉进行了症状学评估。受试者中男性24名，女性9名。48次音乐幻觉发作的持续时间各不相同。它们在精神分裂症病程中的任何时候都可能出现，其中9次（18.8%）发生在确诊之前。所有发作可分为三个阶段：17次（35.4%）为第一阶段，接近强迫观念；5次（10.4%）为第二阶段，接近施奈德一级症状；26次（54.2%）为第三阶段，即原发性体验。在38次发作中，声音存在于主观空间，且在大多数情况下，其内容是熟悉的。第二阶段与异源性体验（“gemachtes Erlebnis”）和思维听觉有关，歌词通常不存在的旋律中加入了词语。精神分裂症中的音乐幻觉是源于记忆表象的假性幻觉，它们可能会转变为真性幻觉。作者认为这三个阶段与疾病的严重程度有关。
