a 30-year - old person , married , with a strong inclination to music composing and song writing besides singing most of them himself started to develop intrusive memories of songs that he had composed , and the tunes would keep coming to his mind even when he was resting .
he started to become increasingly more anxious when these thoughts became associated with recurrent images of him either humming a new or an old tune .
he would keep thinking of the various instruments that he would play to accompany the lyrics and would not be satisfied with any of these thoughts .
he realized over the next few months that he was unable to concentrate at his work and knew that these thoughts and images were of his own making .
he would experience various songs of melodies that would repeatedly and uncontrollably run through his mind .
certain musical passages were more troublesome than others ; these included songs from old and new films or the songs that he had written himself .
he recognized his preoccupation with these melodies to be his own thoughts , he found them intrusive and profoundly anxiety provoking .
he realized that the experiences were unusual , and possibly not normal , and made attempts to resist them , usually with little success .
he reported the experience of obsessive verses , in which various lines of poetry or song tunes composed would keep repeatedly running through his mind .
he also developed obsessive thoughts of repeated checking , correcting , and maintenance of symmetry compulsions .
the symptom and distress would reduce on yielding to compulsions , and the musical obsessions would spontaneously disappear for about 30 minutes after onset , generally in response to some distraction .
he was managed with tab fluvoxamine 200 mg / day , cap fluoxetine 60 mg od , and tab lithium 900 mg / day , latter being used as augmentation .
he showed subjective response after 4 weeks of therapy , and at the end of 8 weeks , there was significant fall in score on the yale brown obsessive compulsive scale .
he was followed up over the next 6 months , and he showed near remission of symptoms .
one reference , describing miscellaneous form of obsessions , in which a 23-year - old lady could not  rid her consciousness of a currently popular tune .
 the other reference appears towards the end of the yale - brown obsessive compulsive symptom checklist , along with several other entries in the category of  miscellaneous obsessions listed as  intrusive nonsense sounds , words , or music(bech , 1993 ) .
musical obsessions maybe rare ; or , they may be commoner than realized but , because of lack of highlighting in psychiatric literature , are not asked after or during the clinical interview . hence , specific details need to be specifically sought . furthermore , experiencing a haunting tune is not an unusual experience ;
the difference between being haunted and being obsessed by a tune could be a difficult distinction , which would deter the average patient 's spontaneous reporting . some phenomenological issues merit attention .  musical obsessions  may be considered to be a special form of imagery , presenting more in the auditory rather than in the visual modality .
this leads to the speculation : may obsessional imagery exist in other sensory , modalities as well ?
the term  obsessive images may then need to be replaced , by the more appropriate expression , sensory obsessions . in psychiatry , as seen usually in ocd patients , common themes are preoccupation with dirt , sex , or religion .
one is tempted to think about the extent to which individual specific life circumstances may produce individual - specific themes ; the experience of musical obsessions by a full - time musician is a case in point as described .
 obsessive - compulsive disorder ( ocd ) is a common psychiatric illness . 
 a case of ocd is presented , in which the chief symptom was recurrent imagery of musical sounds of different instruments experienced by the person . 
 patient was a musician who played various musical instruments . 
 such obsessions with predominant musical themes , lyrics , and tunes have not been described in detail in standard textbooks of psychiatry or phenomenology , nor are they considered in the various diagnostic procedures for ocd . 
 these symptoms are rare and may , at times , go unnoticed because of low clinical awareness . 
CASE REPORT
DISCUSSION