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Id f20b777c-190a-4b69-96e2-d43ffe25b580
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  • (Erfanian et al., 2018)
Dv Initial Source Misophonia MOCMisophonia ]
Dv Limitations • Small final sample size • Cross-sectional design limits causal inference • Reliance on self-report and interview measures • Lack of control group
Dv Future Directions • Larger, controlled studies to clarify causal pathways • Longitudinal designs to examine temporal relationships • Neurobiological investigations to refine nosology and treatment targets
Dv Relevance • old study on Misophonia

MISOPHONIA, EMOTIONAL DYSREGULATION AND AFFECTIVE DISORDERS: A PRELIMINARY STUDY

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Abstract

Background Misophonia is characterized by aversive reactivity to repetitive and pattern based auditory (and sometimes visual) stimuli1. When faced with stimuli, misophonia sufferers demonstrate autonomic nervous system arousal, accompanied by heightened emotional reactivity. Sufferers describe extreme irritation, the desire to get away from the stimuli (or flee), anger, feelings of helplessness, being overwhelmed, and aggressive urge with physiological reactions including hypertonia, diaphoresis and tachycardia2. Some studies have found comorbidity with psychiatric disorders. However, most of these studies used small samples and very few experimental methodologies3. Despite the paucity of empirically based and large sample studies it is important to study the relationship between affective disorders and their symptoms because people with misophonia suffer from a high level of emotional distress. The purpose of this study is to identify possible overlapping characteristics between misophonia and affective disorders based on DSM-5 and ICD-10 diagnoses. Despite the idiopathic nature of the disorder the small but emerging body of literature begins to contribute to a better understanding of its underlying mechanisms, illuminate nosology, and translate into appropriate treatment methods.
Objective The current study identifies (a) the possible relationship between Misophonia and affective disorders (b) if there is any difference between the severity of misophonia in male and female patients.
Methods and materials 86 misophonic patients (female=54, mean age= 46.28, SD=1.57) with no history of active substance abuse within 6 months, no prior treatment of any kind, who were free of hormonal and psychotropic medication were recruited in our study. We evaluated the diagnosis of misophonia with A-MISO-S and diagnosis of affective disorders with the M.I.N.I International Neuropsychiatric Interview. Out of 86 patients, 36 participants were excluded from the study due to incomplete questionnaires or unwillingness to continue.
Results Among N=50 misophonic patients (major depression = 11, melancholic depression= 5, dysthymia= 11, suicidality= 10, manic= 3, panic disorder= 8, agoraphobia= 5, social phobia= 7, obsessive compulsive disorder= 14, post traumatic stress disorder= 15). Misophonia was associated with MDD (U= 76, p= .001), Suicidality (U= 67, p=.001), OCD (U= 115, p= .002) and PTSD (U=142.5, p=.008) as well as the positive correlation between severity of misophonia and MDD (rs= .486, p<.0005), Suicidality (rs= .484, p<.0005), OCD (rs= .444, p= .001) and PTSD (rs=.381, p=.006). There was an indication of a significant difference between men and women in severity of misophonia (U= 160.5, p=.002).
Conclusion Misophonia is associated with major depression, suicidality, OCD and PTSD. Our findings highlight the importance of recognizing affective comorbidity among misophonic patients. The presence of these varying affective disorders features with misophonia suggests that while Misophonia has unique clinical characteristics that suggest an underlying neurophysiological mechanism, the sufferers are at high risk for affective disorders.

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Article Review table
Background/Purpose Background-
• Misophonia involves strong emotional (e.g., anger, irritation, helplessness) and physiological reactions to trigger stimuli.
• Prior literature suggests psychiatric comorbidity, but:
• Existing studies often rely on small samples.
• There is a lack of experimental and systematic diagnostic methodologies.
• Misophonia is considered idiopathic, and its nosological status remains unclear.
• High emotional distress in misophonia highlights the importance of examining overlap with affective disorders.

Purpose-
• Primary goal:
• Identify relationships between misophonia and affective disorders diagnosed via DSM-5 and ICD-10 criteria.

• Secondary goal:
• Examine sex differences in misophonia severity (male vs. female patients).
Participants/samples • Initial recruitment: N = 86 misophonic patients
• Female = 54
• Mean age = 46.28 years (SD = 1.57)

• Final analyzed sample: N = 50
• 36 participants excluded due to incomplete questionnaires or withdrawal.

• Inclusion criteria:
• Diagnosis of misophonia
• No active substance abuse in past 6 months
• No prior treatment for misophonia
• Free of hormonal and psychotropic medications
-
Measures
• Misophonia severity:
• Amsterdam Misophonia Scale (A-MISO-S)

• Psychiatric diagnoses:
• Mini International Neuropsychiatric Interview (M.I.N.I.)

• Diagnostic categories assessed:
• Major depressive disorder (MDD)
• Melancholic depression
• Dysthymia
• Suicidality
• Manic symptoms
• Panic disorder
• Agoraphobia
• Social phobia
• Obsessive–compulsive disorder (OCD)
• Post-traumatic stress disorder (PTSD)
Procedures • Participants underwent:
• Diagnostic confirmation of misophonia using A-MISO-S
• Structured psychiatric interview (M.I.N.I.) for affective and anxiety-related disorders
• Cross-sectional, correlational design
Results • Prevalence of comorbid diagnoses (N = 50):
• Major depression: 11
• Melancholic depression: 5
• Dysthymia: 11
• Suicidality: 10
• Manic symptoms: 3
• Panic disorder: 8
• Agoraphobia: 5
• Social phobia: 7
• OCD: 14
• PTSD: 15

• Significant associations with misophonia:
• Major depressive disorder (U = 76, p = .001)
• Suicidality (U = 67, p = .001)
• OCD (U = 115, p = .002)
• PTSD (U = 142.5, p = .008)

• Severity correlations:
• Misophonia severity positively correlated with:
• MDD (r = .486, p < .0005)
• Suicidality (r = .484, p < .0005)
• OCD (r = .444, p = .001)
• PTSD (r = .381, p = .006)

• Sex differences:
• Women showed significantly greater misophonia severity than men (U = 160.5, p = .002)
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Discussion/Limits Conclusion-
• Misophonia is significantly associated with:
• Major depression
• Suicidality
• OCD
• PTSD

• Findings support the presence of substantial affective comorbidity in misophonia.
• Results suggest misophonia may involve a distinct neurophysiological mechanism while conferring elevated risk for mood and anxiety-related disorders.
• Clinical screening for affective disorders in misophonia—and vice versa—is strongly warranted.

Limitations:: • Small final sample size
• Cross-sectional design limits causal inference
• Reliance on self-report and interview measures
• Lack of control group
Future Directions:: • Larger, controlled studies to clarify causal pathways
• Longitudinal designs to examine temporal relationships
• Neurobiological investigations to refine nosology and treatment targets
Relevance:: • old study on Misophonia

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