Did You Know That Misophonia Was Defined From 42 Patients?

Researchers At One Amsterdam Hospital Interviewed Every One Of Them

Until Then The Condition Was Absent From The Psychiatric Literature

Only Two Case Reports Existed In Other Medical Fields

They Proposed A Set Of Criteria Based On Those Patients

Misophonia Still Has No Official Diagnostic Classification

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OKAY BACK FROM THE AMSTERDAM CLINIC 🏥

The Proposed Diagnosis Came From Forty Two Case Files At One Hospital

They Found The Clinic Through Its Own Website

The Clinic Operated Inside The Academic Medical Center In Amsterdam

Five Psychiatrists Split The Standard Interviews Between Them

All Five Specialized In Obsessive Compulsive Spectrum Disorders

Each Patient Also Completed A Set Of Symptom Scales

One Scale Adapted The Yale Brown Obsessive Compulsive Scale

A Second Scale Determined The Patients Level Of Depression

Another Measured The Severity Of Anxiety Symptoms

A Fourth Scale Checked For Personality Disorder Traits

The Fifth Was A General Checklist For Mental Symptoms

Researchers Found One Shared Pattern Across All 42 Patients

A Sound Or A Sight Triggered An Immediate Physical Reaction

The Reaction Started As Irritation Or Disgust Then Became Anger

Anger Sometimes Escalated Into Impulsive Aggression

Patients Then Grew Obsessed With The Triggering Cue

All Of Them Actively Avoided The Misophonic Situations

That Avoidance Caused Real Social Dysfunction And Suffering

Eating Sounds Were The Most Common Trigger At 81 Percent

Breathing Or Nose Sounds Were Named By 64.3 Percent

Keyboard Typing Or Pen Clicking Bothered 59.5 Percent

The Same Paper Wrote Down A Set Of Proposed Criteria

Criterion One Names The Trigger As A Sound Made By A Person

Eating Sounds And Breathing Sounds Are The Given Examples

That Sound Provokes A Reaction Starting As Irritation Or Disgust

The Reaction Becomes Anger Almost Instantly

Criterion Two Describes A Loss Of Self Control

That Loss Of Control Can Include Rare Aggressive Outbursts

Criterion Three Says The Person Knows The Anger Is Excessive

They Recognize It As Out Of Proportion To The Trigger

Criterion Four Covers Avoidance Of The Triggering Situation

Enduring The Sound Instead Brings Intense Discomfort Or Anger

Criterion Five Requires Real Distress Or Real Interference

That Interference Can Affect Work Friendships Or Attending Class

Criterion Six Excludes A Better Explanation

Obsessive Compulsive Disorder Is One Excluded Alternative

Post Traumatic Stress Disorder Is The Other One Excluded

The Paper Also Introduced A Severity Scale Called The A-MISO-S

That Scale Adapted An Existing Obsessive Compulsive Rating Tool

Patients Scored Severe On That Scale On Average

Their Average Score Was 15.1 Out Of A Possible 24

The Same Paper Discussed How To Classify These Symptoms

It Said The Symptoms Could Not Fit DSM-IV-TR Or ICD-10

Those Were The Two Manuals In Use At The Time

The Authors Concluded Misophonia Should Become Its Own Disorder

A Formal Diagnosis Would Help Recognize The Patients

It Would Also Help Health Professionals Identify The Condition

This Would Encourage More Scientific Research Into It

A Second Suggestion Appears In The Same Discussion

That Idea Proposed An Obsessive Compulsive Spectrum Category

This Category Groups Disorders That Share Obsession Or Impulsivity

The Authors Called That Classification Premature In Their Own Words

They Noted The Spectrum Itself Is Still Debated By Researchers

Misophonia Was Then Compared With Other Listed Diagnoses

Specific Phobia Was One Of Them

In Specific Phobia The Emotion Is Anxiety Not Aggression

Obsessive Compulsive Disorder Was On The Same List

In That Disorder Patients Tend To Perform Compulsive Acts

None Of Those Categories Fit The Whole Symptom Pattern