Saba P R, Keshavan M S
Western Psychiatric Institute and Clinic, Pittsburgh, Pa., 15219, USA.
Psychopathology. 1997;30(4):185-90. doi: 10.1159/000285046.
The discussion of auditory hallucinations in schizophrenia has traditionally focused on verbal auditory hallucinations, or 'voices'. Little attention, on the other hand, has been given to the phenomenon of musical hallucinations. In an effort to characterize the prevalence and phenomenology of musical hallucinations, 100 consecutive schizophrenic inpatients were examined for the presence of musical hallucinations and musical imagery. Sixteen patients responded positively, and were engaged in a more thorough interview. They were then divided into two groups: those with musical hallucinations, and those experiencing musical imagery. This determination was made based on the absence or presence, respectively, of volitional control, hypothesizing that lack of volitional control implies a true hallucinatory experience. When lack of volitional control was compared to the various other aspects of the experience, an association with religious content was demonstrated. Religious musical hallucinations also tended to be experienced as distressing, further supporting the hypothesis that the experience was hallucinatory rather than a product of volitional imagery. A selection of sample case vignettes is presented as well.
传统上，对精神分裂症中幻听的讨论主要集中在言语性幻听，即“声音”上。另一方面，音乐性幻听现象很少受到关注。为了描述音乐性幻听的患病率和现象学特征，对100名连续住院的精神分裂症患者进行了音乐性幻听和音乐意象检查。16名患者给出了肯定回答，并接受了更深入的访谈。然后将他们分为两组：有音乐性幻听的患者和有音乐意象体验的患者。这一划分分别基于是否存在意志控制，假设缺乏意志控制意味着真实的幻觉体验。当将缺乏意志控制与体验的其他各个方面进行比较时，发现与宗教内容有关联。宗教性音乐性幻听也往往会带来痛苦，这进一步支持了该体验是幻觉而非意志性意象产物的假设。同时还展示了一些样本病例 vignettes。
