MISOPHONIA, EMOTIONAL DYSREGULATION AND AFFECTIVE DISORDERS: A PRELIMINARY STUDY

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 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. Conversely, when assessing patients with affective disorders is important screen for misophonia symptoms. This will assist researchers, clinicians and sufferers to better understand the nature of their symptoms and how they may be interacting. In addition, from this small sample, it appears that women experience more severe misophonic symptoms than men.