Misophonia is defined as an abnormally strong emotional and behavioral reaction to particular sounds or groups of sounds that have a specific pattern and meaning to the patient (Jastreboff & Jastreboff 2003), although a consensus paper bringing together experts from a wide range of disciplines suggested using the term “annoyance hyperacusis” for the experience of negative emotional reaction to sound (Tyler et al. 2014). Andrea E. Cavanna (Department of Neuropsychiatry, Birmingham, UK) discussed the possible mechanisms underlying misophonia.

Professor Andrea E. Cavanna

Although misophonia is not listed in any major psychiatric classification system, a few psychiatric clinics have reported treating patients with misophonia (Bernstein et al. 2013; McGuire et al. 2015; Schroder et al. 2013; Webber et al. 2014). Systematic studies of misophonia are very limited (Cavanna & Seri 2015). In the field of psychiatry, there is a growing debate as to whether misophonia is a distinct psychiatric disorder or a variety of hyperacusis that is often co-morbid with neuropsychiatric disorders (Cavanna 2014; Cavanna & Seri 2015; Neal & Cavanna 2013; Schroder et al. 2013; Taylor 2017). Specifically, neuro-developmental disorders including Tourette syndrome (Cavanna & Seri 2013) and autism spectrum disorder (see the following section) have been shown to be associated with misophonia in a proportion of cases, suggesting shared neuro-developmental trajectories.

Most research studies in the field of audiology have not distinguished misophonia from hyperacusis (Andersson et al. 2002; Fackrell et al. 2015; Juris et al. 2014; Schecklmann et al. 2014; Schecklmann et al. 2015; Sheldrake et al. 2015; Zaugg et al. 2016). Jastreboff and Jastreboff (2015) reported that people with severe hyperacusis always experience misophonia. Recent studies conducted within the National Health Service (NHS) in the UK suggest that severe hyperacusis is typically characterized by strong across-frequency variations in sensitivity to sound, which is an indication of adverse reaction only to specific sounds, a feature that is associated with misophonia (Aazh & Moore 2017; Aazh & Moore 2018).

Based on the above mentioned studies, it is likely that misophonia forms part of the spectrum of hyperacusis and needs to be considered when assessing patients with sound intolerance complaints.

Dr. Hashir Aazh

References