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Id acdd5036-b470-444b-8fa7-61b822fd58b4
Year 2025
Abstract Misophonia is a condition that causes strong emotional reactions to specific sounds, leading to feelings of anger, irritation, or disgust. People affected by this condition may experience intense negative responses to sounds such as chewing, breathing, or tapping, which can greatly impact their daily lives and relationships. Those with misophonia may go to great lengths to avoid these trigger sounds. Treatment for misophonia typically involves therapy and coping strategies to help individuals better manage their reactions and enhance their quality of life. Despite its significant impact, misophonia has not yet been officially recognized in psychiatric classification systems. Some experts believe it should be classified as a distinct mental disorder due to its unique characteristics. There is still limited knowledge about misophonia, with only a few reported cases, and the causes, risk factors, and connections to other mental health conditions remain unclear. It is a relatively new and often overlooked phenomenon that requires further research into its epidemiology, symptoms, brain activity, and potential treatment options. In this study, we present three cases of individuals experiencing misophonia symptoms and the treatment approaches used.
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- The Melody of Discomfort
- (Shamla et al., 2025)
Import Date 12-06-2025
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Dv Authors
Dv Initial Source Misophonia MOCMisophonia
Dv Status #status/Bare-bones-review
Dv Limitations • Small sample size (case series). • No objective physiological or neuroimaging data were collected. • Longitudinal data limited to follow-up in Case 3.
Dv Future Directions • Investigate the pathophysiological basis (e.g., brain connectivity abnormalities). • Establish standardized diagnostic criteria and therapeutic protocols. • Evaluate pharmacological vs. behavioral treatments in controlled trials. • Explore misophonia's relation to other sensory sensitivities and comorbidities
Dv Relevance • a collection of descriptive case studies of people (N =3) with Misophonia, describing their symptoms, diagnostic profiles ,and treatment responses. • all three were assessed with the Misophonia response Scale to be categorized as Misophonic. • all three were diagnosed with OCD by the author and treated with combos of CBT and medication (one or more of the following: fluoxetine, clonazepam, propranolol), sertraline. they all showed improvements but it is unclear if this is a true Misophonia thing or the result of treating co occurring OCD. • A decent source for example case studies. could be useful to highlight the need to separate co occurring disorders like OCD.
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The Melody of Discomfort: Exploring Misophonia - A Case Series
Status:: #status/Bare-bones-review
Metadata
- Item Type: #journalArticle
- Authors:: Fatima Shamla, Jaideep Patil, Suprakash Chaudhury, Bhushan Chaudhari, Suvayan Saha,
- Date:
- Date Added: 1764877192000
- URL: https://journals.lww.com/10.4103/mjdrdypu.mjdrdypu_303_24
- DOI: 10.4103/mjdrdypu.mjdrdypu_303_24
- Cite Key: shamlaMelodyDiscomfortExploring2025
- Topics: [object Object]
- Tags:: #Misophonia, #Bare-bones-review-🦴, #trigger-sounds, #case-report,
- PDF Attachments
Abstract
| Background/Purpose | Background- • Misophonia, though not currently recognized in DSM-5 or ICD-11, involves intense negative reactions to specific sounds and is often misunderstood. • The condition differs from hyperacusis and phonophobia in emotional and physiological response profiles. • A 2022 expert consensus defined misophonia as a standalone disorder. • Neuroimaging studies suggest misophonia is associated with increased activity in the anterior insular cortex and amygdala, suggesting abnormal emotional processing circuits. • Misophonia is frequently comorbid with psychiatric disorders such as OCD, anxiety, and depression. Purpose- • To present three clinical case reports of individuals with misophonia symptoms and describe their diagnostic profiles and therapeutic responses. • To highlight the potential for pharmacological and behavioral interventions in misophonia management. |
| Participants/samples | • N = 3 patients (2 female, 1 male), ages ranging from 32 to 49. • All were middle- to upper-class individuals from urban India. • All had comorbid OCD diagnoses. |
| Measures | • Misophonia Response Scale (scores: 37, 40, 39 for cases 1–3 respectively). |
| Procedures | All patients underwent psychiatric evaluations and were treated with medications (SSRIs, clonazepam, propranolol) and non-pharmacologic therapies (CBT, relaxation techniques). |
| Results | • All three patients demonstrated significant sensitivity to specific sounds, leading to anxiety, preoccupation, and social/occupational dysfunction. • Pharmacologic intervention with SSRIs (fluoxetine or sertraline) and behavioral therapy (CBT and relaxation training) led to varying degrees of symptom improvement: • Case 1: Near-total symptom remission after 4 months. • Case 2: Recurrent symptoms seasonally; temporary relief with medication. • Case 3: Sustained improvement over 2 years with reduced medication. |
| Discussion/Limits | Conclusion- • Misophonia involves distressing, trigger-specific emotional and physiological responses, often overlapping with OCD. • Treatment involving SSRIs and CBT appears effective, though large-scale, controlled studies are lacking. • The presence of anticipatory anxiety and hypervigilance was common across cases. • Misophonia significantly disrupts functioning, yet lacks formal psychiatric recognition or treatment guidelines. |
| Limitations:: | • Small sample size (case series). • No objective physiological or neuroimaging data were collected. • Longitudinal data limited to follow-up in Case 3. |
| Future Directions:: | • Investigate the pathophysiological basis (e.g., brain connectivity abnormalities). • Establish standardized diagnostic criteria and therapeutic protocols. • Evaluate pharmacological vs. behavioral treatments in controlled trials. • Explore misophonia's relation to other sensory sensitivities and comorbidities |
| Relevance:: | • a collection of descriptive case studies of people (N =3) with Misophonia, describing their symptoms, diagnostic profiles ,and treatment responses. • all three were assessed with the Misophonia response Scale to be categorized as Misophonic. • all three were diagnosed with OCD by the author and treated with combos of CBT and medication (one or more of the following: fluoxetine, clonazepam, propranolol), sertraline. they all showed improvements but it is unclear if this is a true Misophonia thing or the result of treating co occurring OCD. • A decent source for example case studies. could be useful to highlight the need to separate co occurring disorders like OCD. |
Notes
Key terms and concepts
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Misophonia – A condition marked by intense emotional and physiological responses (e.g., anger, anxiety, disgust) to specific trigger sounds such as chewing, breathing, or tapping.
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Phonophobia – A sound-related disorder distinct from misophonia, characterized by fear-based reactions to specific sounds.
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Hyperacusis – Heightened sensitivity to sound volume or frequency, distinct from the emotionally charged responses seen in misophonia.
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Misophonia Response Scale – A standardized scale used to quantify an individual's sensitivity to misophonic triggers.
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Selective Serotonin Reuptake Inhibitors (SSRIs) – A class of antidepressants (e.g., fluoxetine, sertraline) used as part of the pharmacological treatment for misophonia-related symptoms.
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CBT (Cognitive Behavioral Therapy) – A structured, evidence-based psychotherapy often used to manage obsessive-compulsive disorder and misophonia
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Comorbidity Patterns
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All patients had OCD, underscoring a strong correlation.
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Misophonia may also co-occur with mood disorders, PTSD, ADHD, Tourette’s, and eating disorders.
Treatment Stratification
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Exposure and response prevention is promising for anxiety-dominant misophonia.
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Cognitive restructuring may be better for anger-dominant cases.
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Mindfulness and acceptance-based therapies (DBT, ACT) mentioned as potential alternatives.
Functional Impairments
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Misophonia led to hypervigilance, social withdrawal, and reduced productivity.
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Patients went to great lengths to avoid triggers (e.g., leaving locations, confrontation, preoccupation)