title: Musical obsessions: a comprehensive review of neglected clinical phenomena.
abstract: Intrusive musical imagery (IMI) consists of involuntarily recalled, short, looping fragments of melodies. Musical obsessions are distressing, impairing forms of IMI that merit investigation in their own right and, more generally, research into these phenomena may broaden our understanding of obsessive-compulsive disorder (OCD), which is phenomenologically and etiologically heterogeneous. We present the first comprehensive review of musical obsessions, based on the largest set of case descriptions ever assembled (N=96). Characteristics of musical obsessions are described and compared with normal IMI, musical hallucinations, and visual obsessional imagery. Assessment, differential diagnosis, comorbidity, etiologic hypotheses, and treatments are described. Musical obsessions may be under-diagnosed because they are not adequately assessed by current measures of OCD. Musical obsessions have been misdiagnosed as psychotic phenomena, which has led to ineffective treatment. Accurate diagnosis is important for appropriate treatment. Musical obsessions may respond to treatments that are not recommended for prototypic OCD symptoms.
authors.affiliation: University of British Columbia, BC, Canada. Electronic address: taylor@mail.ubc.ca.
authors.forename: Steven
authors.initials: S
authors.lastname: Taylor
authors.affiliation: Fordham University, NY, USA.
authors.forename: Dean
authors.initials: D
authors.lastname: McKay
authors.affiliation: University of São Paulo Medical School, Brazil.
authors.forename: Euripedes C
authors.initials: EC
authors.lastname: Miguel
authors.affiliation: University of São Paulo Medical School, Brazil.
authors.forename: Maria Alice
authors.initials: MA
authors.lastname: De Mathis
authors.affiliation: National Institute of Mental Health and Neurosciences, India.
authors.forename: Chittaranjan
authors.initials: C
authors.lastname: Andrade
authors.affiliation: Northumberland, Tyne and Wear NHS Foundation Trust, UK.
authors.forename: Niraj
authors.initials: N
authors.lastname: Ahuja
authors.affiliation: McGill University, PQ, Canada.
authors.forename: Debbie
authors.initials: D
authors.lastname: Sookman
authors.affiliation: Seoul National University, Republic of Korea.
authors.forename: Jun Soo
authors.initials: JS
authors.lastname: Kwon
authors.affiliation: Seoul National University, Republic of Korea.
authors.forename: Min Jung
authors.initials: MJ
authors.lastname: Huh
authors.affiliation: Rogers Memorial Hospital, WI, USA.
authors.forename: Bradley C
authors.initials: BC
authors.lastname: Riemann
authors.affiliation: University Lyon 1, France.
authors.forename: Jean
authors.initials: J
authors.lastname: Cottraux
authors.affiliation: Centre de Recherche, University Institute of Mental Health at Montreal, PQ, Canada.
authors.forename: Kieron
authors.initials: K
authors.lastname: O'Connor
authors.affiliation: Kansas City Center for Anxiety Treatment, KS, USA.
authors.forename: Lisa R
authors.initials: LR
authors.lastname: Hale
authors.affiliation: University of North Carolina at Chapel Hill, NC, USA.
authors.forename: Jonathan S
authors.initials: JS
authors.lastname: Abramowitz
authors.affiliation: Federal University of Rio de Janeiro, Brazil.
authors.forename: Leonardo F
authors.initials: LF
authors.lastname: Fontenelle
authors.affiliation: Rogers Memorial Hospital, WI, USA; University of South Florida, FL, USA.
authors.forename: Eric A
authors.initials: EA
authors.lastname: Storch
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014150:Antipsychotic Agents / Q000627:therapeutic use; D001362:Avoidance Learning; D002648:Child; D015928:Cognitive Behavioral Therapy / Q000379:methods; D003937:Diagnosis, Differential; D005239:Fear; D005260:Female; D006212:Hallucinations / Q000175:diagnosis / Q000523:psychology; D006801:Humans; D007092:Imagination; D008297:Male; D008875:Middle Aged; D008960:Models, Psychological; D009146:Music; D009770:Obsessive Behavior / Q000175:diagnosis* / Q000523:psychology / Q000628:therapy; D009771:Obsessive-Compulsive Disorder / Q000175:diagnosis* / Q000523:psychology / Q000628:therapy; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use; D055815:Young Adult
chemical_list: D014150:Antipsychotic Agents; D017367:Selective Serotonin Reuptake Inhibitors
keywords: Earworms; Intrusive musical imagery; Involuntary musical imagery; Musical obsessions; Obsessive-compulsive disorder; Orhwurms