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Year 2025
Abstract Background: The aim of this study was to conduct a systematic review of the research literature on the prevalence of psychiatric comorbidities in patients with hyperacusis and misophonia. Method: Four databases were searched: PubMed, PsycINFO, Scopus, and Web of Science (Wis)—last search conducted on the 16th of April 2024 to identify relevant studies. The methodological quality of each study was independently assessed using the JBI Critical Appraisal Checklist. Results: Five studies were included for the prevalence of psychiatric comorbidities in hyperacusis, and seventeen studies for misophonia. Among patients with hyperacusis, between 8% and 80% had depression, and between 39% and 61% had any anxiety disorder as measured via a diagnostic interview and/or self-report questionnaires. For misophonia, nine studies provided data on various forms of mood and anxiety disorders, with prevalences ranging from 1.1% to 37.3% and 0.2% to 69%, respectively. Conclusions: Although the 22 included studies varied considerably in design and scope, some recurring patterns of comorbidity were noted. However, apparent trends—such as the higher prevalence of mood and anxiety disorders compared to other psychiatric conditions—should be interpreted with caution, as most studies did not comprehensively assess a full range of psychiatric disorders. This likely skews prevalence estimates toward the conditions that were specifically investigated.
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- Psychiatric Comorbidities in Hyperacusis and Misophonia
- (Rodrigues & Aazh, 2025)
Import Date 01-25-2026
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Dv Authors Ana Luísa Moura Rodrigues, Hashir Aazh,
Dv Initial Source Misophonia MOC
Dv Status #status/Bare-bones-review
Dv Limitations • Many studies used non-representative samples (e.g., clinical referrals, students) • Several relied on self-report rather than structured clinical interviews, affecting diagnostic accuracy • Diagnostic tools varied, leading to heterogeneity in prevalence estimates
Dv Future Directions • Standardization of diagnostic criteria and assessment tools for misophonia and hyperacusis • Longitudinal and representative epidemiological studies • Greater focus on neurodevelopmental and personality comorbidities • Exploration of mechanisms linking sound sensitivity and psychopathology
Dv Relevance • a good review on the existing info of Misophonia comorbidity leading up to the time of this publication • primarily a good reference for comorbidity data.
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Psychiatric Comorbidities in Hyperacusis and Misophonia: A Systematic Review
Status:: #status/Bare-bones-review
Metadata
- Item Type: #journalArticle
- Authors:: Ana Luísa Moura Rodrigues, Hashir Aazh,
- Date:
- Date Added: 1755660931000
- URL: https://www.mdpi.com/2039-4349/15/4/101
- DOI: 10.3390/audiolres15040101
- Cite Key: rodriguesPsychiatricComorbiditiesHyperacusis2025
- Topics: [object Object]
- Tags:: #Misophonia, #literature-review, #Bare-bones-review-🦴, #clinical, #hyperacusis, #comorbidity, #sound-sensitivity, #decreased-sound-tolerance-(DST),
- PDF Attachments
Abstract
| Background/Purpose | Background- • Both hyperacusis and misophonia are associated with distress and psychiatric symptoms, but the precise prevalence and range of psychiatric comorbidities remain unclear. • Existing literature has inconsistently reported on psychiatric overlap, often focusing narrowly on depression or anxiety without assessing a full psychiatric profile. • Misophonia is increasingly recognized in the psychiatric literature, but diagnostic criteria are still emerging. Hyperacusis research often overlaps with tinnitus, adding complexity to its clinical profile. Purpose- • To systematically review and synthesize prevalence data on psychiatric comorbidities associated with hyperacusis and misophonia. • To identify trends in co-occurring psychiatric diagnoses using validated clinical and epidemiological tools. • To inform diagnostic clarity and treatment planning for these sound sensitivity conditions. |
| Participants/samples | Sample • 22 studies included: 5 hyperacusis-related, 17 misophonia-related • Total of 6,473 participants: 4,699 with hyperacusis; 1,774 with misophonia • Studies conducted across 9 countries; most published in the past 5 years • Participants included both clinical and community samples; some studies included children or adolescents Inclusion criteria • Quantitative studies reporting prevalence of psychiatric disorders using validated diagnostic tools or structured interviews • Included cross-sectional, case-control, cohort, and RCT designs • Excluded case reports, qualitative studies, and non-validated diagnostic methods |
| Measures | N/A |
| Procedures | N/A |
| Results | Hyperacusis • Depression prevalence: Ranged from 8% (diagnostic interview) to 80% (PHQ-9 self-report) • Anxiety prevalence: Ranged from 39% to 61%; GAD, social anxiety, panic disorder, OCD, PTSD assessed variably • Other psychiatric comorbidities: Somatoform disorder (22%), alcohol use (5%), eating disorders (2%) Misophonia • Depression (MDD): Reported in 10 studies; prevalence 1.1%–18.4% • Suicidality: Ranged from 1.92% to 20% • Anxiety disorders: Generalized anxiety (1%–36.2%), social anxiety (1.2%–30.9%), panic disorder, PTSD, phobias • OCD: Prevalence 2.1%–39.8% • Eating disorders: Anorexia (up to 14.9%), bulimia, binge eating • Substance use: Alcohol (1%–11%), cannabis, stimulants • Neurodevelopmental: ADHD (1.7%–21%), autism spectrum disorder (up to 21.4%) • Personality disorders: OCPD (2.4%–52.4%), BPD, avoidant and dependent PD • Other psychiatric: Hypochondriasis, psychotic disorders, intermittent explosive disorder |
| Discussion/Limits | Conclusion- • Both hyperacusis and misophonia are consistently associated with higher rates of psychiatric comorbidities, especially mood and anxiety disorders. • Comorbid psychiatric symptoms likely influence symptom severity and should be considered in clinical treatment planning. • The conditions are not linked to one specific psychiatric disorder but show a wide range of co-occurring psychopathologies. |
| Limitations:: | • Many studies used non-representative samples (e.g., clinical referrals, students) • Several relied on self-report rather than structured clinical interviews, affecting diagnostic accuracy • Diagnostic tools varied, leading to heterogeneity in prevalence estimates |
| Future Directions:: | • Standardization of diagnostic criteria and assessment tools for misophonia and hyperacusis • Longitudinal and representative epidemiological studies • Greater focus on neurodevelopmental and personality comorbidities • Exploration of mechanisms linking sound sensitivity and psychopathology |
| Relevance:: | • a good review on the existing info of Misophonia comorbidity leading up to the time of this publication • primarly a good refernce for comorbidity data. |
Notes
Key terms
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Hyperacusis – Decreased tolerance to everyday environmental sounds that are perceived as too loud or distressing, not due to hearing loss, often categorized into four subtypes: loudness, fear, pain, and annoyance hyperacusis.
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Misophonia – A condition marked by extreme emotional and behavioral responses (e.g., anger, disgust) to specific pattern-based trigger sounds (e.g., chewing, sniffing).
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Psychiatric comorbidity – Co-occurrence of one or more diagnosable psychiatric disorders alongside a primary condition such as hyperacusis or misophonia.
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MINI – Mini-International Neuropsychiatric Interview, a structured diagnostic tool for DSM and ICD psychiatric disorders.
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SCID – Structured Clinical Interview for DSM Disorders, a semi-structured diagnostic interview used to determine DSM diagnoses.
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PHQ-9 – Patient Health Questionnaire, a screening tool for the severity of depressive symptoms.
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DASS-21 – Depression, Anxiety and Stress Scale, a self-report scale to assess emotional states of depression and anxiety.