Psychotic disorders: musical hallucinations: practice question

A Psychiatry question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Psychiatry · Psychotic disorders: musical hallucinations

Sample item

A 78-year-old woman with long-standing bilateral hearing loss hears hymns and old film songs playing in the house, mostly at night. She knows the music is not real, and she has no delusions, memory loss or mood disturbance. What is the most likely explanation?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

A. Musical hallucinosis associated with hearing loss

Musical hallucinations are most often seen in older women with hearing impairment, a release-type phenomenon, and the patient usually retains insight. Management is hearing correction, reassurance, and sometimes low-dose medication. Epilepsy or lesions are uncommon causes.

Option by option

  • A. Musical hallucinosis associated with hearing loss (correct)

    Correct. Hearing loss, intact insight and isolated music fit musical hallucinosis.

  • B. Dementia with Lewy bodies

    Lewy body dementia has visual hallucinations with cognitive fluctuation and parkinsonism.

  • C. Temporal lobe epilepsy

    Temporal lobe epilepsy produces brief stereotyped episodes with impaired awareness, not continuous music with insight.

  • D. Schizophrenia of late onset

    Late-onset schizophrenia would involve delusions and other psychotic features, and insight would be lost.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Psychiatry question

What is the answer to this Psychiatry question?

The best answer is A, Musical hallucinosis associated with hearing loss. Musical hallucinations are most often seen in older women with hearing impairment, a release-type phenomenon, and the patient usually retains insight.

Why is "Dementia with Lewy bodies" not the answer?

Lewy body dementia has visual hallucinations with cognitive fluctuation and parkinsonism.

Why is "Temporal lobe epilepsy" not the answer?

Temporal lobe epilepsy produces brief stereotyped episodes with impaired awareness, not continuous music with insight.

Why is "Schizophrenia of late onset" not the answer?

Late-onset schizophrenia would involve delusions and other psychotic features, and insight would be lost.

What concept does this question test?

It tests Psychotic disorders: musical hallucinations in Psychiatry. Management is hearing correction, reassurance, and sometimes low-dose medication. Epilepsy or lesions are uncommon causes.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Psychotic disorders: musical hallucinations?

Learn each diagnosis by its core features and its first-line treatment. Then use the flashcards and the other Psychiatry questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.