A study of misophonia patients found that about 65% had a diagnosis of at least one other mental illness. The most common additional diagnoses were depression (49%) and anxiety disorders (47%). The paper is psychiatric research.
Misophonia is a condition characterized by intense emotional and physiological reactions to certain everyday sounds. Common trigger sounds include chewing, breathing, tapping, or repetitive clicking sounds. When people with misophonia are exposed to these triggers, they experience anger, disgust, anxiety, or the urge to flee. The reaction is usually immediate and disproportionate to the actual loudness or objective intensity of the sound.
Research suggests that misophonia involves increased connectivity between auditory processing areas and brain areas involved in processing emotional significance, such as detecting stimuli and threats. Unlike common sound hypersensitivity, misophonia usually selectively selects certain patterns rather than all loud noises.
This condition can seriously disrupt social relationships, work, and home life, especially if triggered by someone close to you. Some researchers conceptualize this as involving atypical emotional conditioning to specific auditory (sound) cues. There is ongoing debate as to whether misophonia should be classified as a separate disorder or as associated with anxiety, obsessive-compulsive spectrum conditions, or differences in sensory processing.
Study author Alexandra Freshley and her colleagues note that existing research suggests that misophonia is commonly associated with increased rates of various psychological disorders and auditory sensory disorders. However, previous studies have often relied on biased clinical samples or university convenience samples. To address this, researchers conducted a study using a probability-based, nationally representative sample of U.S. adults to examine the mental health conditions commonly associated with misophonia.
Study participants were 185 people with misophonia drawn from a larger sample of U.S. adults (via Ipsos KnowledgePanel). An additional 1,644 participants in this study who did not report symptoms of misophonia were included as a control group. The mean age of the misophonia group was 41 years, compared to 51 years for the control group. Fifty-three percent of participants with misophonia and 49% of participants in the control group were female.
Study participants completed a misophonia symptom assessment (A-MISO-S and Misophonia Question Severity Scale), which the authors used to identify misophonia patients. Separately, study participants completed screening tests for anxiety (GAD-2) and depressive symptoms (PHQ-2), tinnitus, hyperacusis, autonomic sensory meridian response (ASMR), and hearing loss symptoms. They also completed a checklist regarding their history of psychological, hearing, and communication disorders and indicated whether they had ever been diagnosed with any of the conditions listed.
The results showed that most of the disorders investigated were 2 to 37 times more likely to occur among misophonia patients compared to controls, even after adjusting for demographic factors. Fifty-three percent of misophonia patients screened positive for a current anxiety disorder, compared to only 8% of patients in the control group.
The proportion of people who screened positive for current depression was 42% in participants with misophonia and 6% in the control group. Auditory symptoms were also highly prevalent, with tinnitus (ringing in the ears) reported in 44% of the misophonia group compared to 23% of the control group. Symptoms of hyperacusis (pain or sensitivity to everyday sounds) were present in 42% of misophonia patients, compared to only 2% of controls. The smallest difference was in symptoms of hearing loss (30% in the misophonia group and 26% in the control group).
The situation was similar when looking at self-reported lifetime diagnostic results. 49% of misophonia patients (vs. 11% in the control group) reported being diagnosed with depression, and 47% (vs. 10% in the control group) reported being diagnosed with an anxiety disorder. 29% had PTSD (compared to 3% in the control group).
Overall, 65% of participants with misophonia had a diagnosis of at least one other disorder. There were particular exceptions. After controlling for demographics, misophonia was not significantly associated with an increased likelihood of being diagnosed with autism spectrum disorder (ASD) or repetitive behavior disorders (such as Tourette syndrome or trichotillomania), which differs from some previous smaller studies.
“The results showed that patients with misophonia were significantly more likely to report all mental health, auditory sensory impairment, and communication disorder symptoms and diagnoses, with a few exceptions (such as hyperacusis) (this is an improvement over previous formula “The high rate of comorbidity also highlights the importance of identifying common underlying mechanisms,” the study authors concluded.
This study significantly contributes to scientific knowledge about misophonia by utilizing a nationally representative sample. However, it should be noted that the study data were self-reported, which leaves room for reporting bias.
Furthermore, for some disorders, there were significant differences between the proportion of participants who had previously received a formal diagnosis and the proportion who had elevated symptoms at the time of the study. This reflects the reality that some disorders (such as hyperacusis) are less recognized in everyday clinical practice and people who suffer from these disorders are less likely to seek or receive a formal diagnosis.
The paper, “Clinical correlates of the presence or absence of misophonia in the United States: Results from a population-based study,” was authored by Alexandra Freshley, Heather L. Clark, Mary J. Schadegg, and Laura J. Dixon.
