Occurrence of Psychiatric Comorbidities in Hyperacusis and Misophonia - a Systematic Review

Abstract

Introduction: Decreased sound tolerance among individuals can be divided into two conditions: Hyperacusis and Misophonia. Hyperacusis is the perception of certain everyday sounds as excessively loud or painful. Misophonia, on its hand, is characterized by heightened emotional reaction to a sound with a specific pattern and/or meaning to an individual, with the context in which it occurs being relevant. Scattered evidence from clinical research suggests that Hyperacusis and Misophonia can co-occur with a wide range of psychiatric disorders. The coexistence of a psychiatric comorbidity can affect the severity of the symptoms and, subsequently, the clinical management of these patients. A better understanding of these comorbid conditions is important as it could help to clarify their underlying mechanisms and ultimately to improve the care provided to individuals experiencing them.

Objective: To conduct a systematic review of the available evidence on the prevalence of psychiatric disorders in patients with Hyperacusis and Misophonia, and to explore which factors may influence prevalence estimates.

Methods: This systematic review adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) reporting statement. A protocol was registered in the PROSPERO database (registration number CRD42022347013). The review question was formulated using the CoCoPop (Condition, Context and Population) framework for prevalence and/or incidence reviews and informed the selection criteria. Systematic searches were conducted in four bibliographic electronic databases - PubMed, PsycINFO, Scopus and Web of Science - from inception to 7th of January 2023 to identify relevant studies. The searches were limited to human studies and no date, language or country origin restrictions were applied. The search strategy encompassed terms for "Hyperacusis and Misophonia" and terms related to "Psychiatric Comorbidities". Two authors (ALR and DR) independently screened titles/abstracts and full text articles following the predefined inclusion criteria. The methodological quality and risk of bias were assessed using Joanna Briggs Institute (JBI) Critical Appraisal Checklist for Prevalence and Case-Control studies. Because the studies included were of diverse populations and include a wide range of psychopathology, the data were tabulated and a narrative analysis was conducted.

Results: Out of 663 records initially retrieved, a total of 14 studies, involving 2313 patients, were found to meet the inclusion criteria for this review. Among them, 10 studies focused on describing the prevalence of psychiatric comorbidities in individuals with Misophonia and 4 studies examined psychiatric comorbidities in individuals with Hyperacusis.

Conclusion: This is the first systematic review to report prevalence data of psychiatric comorbidities in Misofonia and Hyperacusis. Despite the heterogeneity observed among the included studies, the available evidence consistently points to a significant prevalence of a wide range of psychiatric comorbidities in patients with Hyperacusis and Misophonia. This finding underscores the importance of screening individuals affected by these conditions for psychiatric disorders.