Bulgarian Journal of Psychiatry, 2023; 8(3):20-26
MULTIDISCIPLINARY APPROACH TO MISOPHONIA MANAGEMENT: OUR ALGORITHM
Oleg Banyra1,2, Oxana Jourkiv3, Viacheslav Didkovskiy4, Oleg Nikitin5, Iryna Ventskivska6, Mykola Chaplia7, Zvenyslava Kechur8
1Department of Urology, St. Paraskeva Medical Centre, Lviv – Ukraine
2Department of Surgery, 2nd Lviv Municipal Polyclinic, Lviv – Ukraine
3Psychiatrist, Psychotherapist, Child and Family Counseling Group, P.L.C., Fairfax, VA – USA
4Department of Otorhinolaryngology, Bogomolets National Medical University, Kyiv – Ukraine
5Department of Urology, Bogomolets National Medical University, Kyiv – Ukraine
6Department of Gynecology, Bogomolets National Medical University, Kyiv – Ukraine
7Department of Urology, Danylo Halytsky Lviv National Medical University, Lviv – Ukraine
8Psychiatrist, Psychotherapist, St. Paraskeva Medical Centre, Lviv – Ukraine
Abstract. Background. Misophonia as a selective sound hypersensitivity is characterized by different negative emotions and behaviors triggered by specific sounds. In general, triggers are produced by people but can be environmental too. In literature misophonia sufferers have been called “misophonics”. Misophonics may experience severe anxiety, disgust, rage and/or fear and other unpleasant feelings when they hear specific individual trigger sounds. The negative emotions impair ability to perform usual daily activities and thus can influence their quality of life. Although there is a certain quantity of misophonics in general population, many specialists and general practitioners face the problems of diagnosing and classifying misophonia. It is relatively new pathology without clear diagnostic/treatment protocol and follow-up. Aims. Based on own experience and newest literature data we aimed to construct multidisciplinary algorithm for misophonia management and to assess the quality of life in sufferers. Material and methods. We analyzed own experience of management of 287 individuals with sound hypersensitivity. Based on standard audiometry testing, we separated subjects with hyperacusis at first. Amsterdam Misophonia Scale questionnaire was a selection tool for sufferers with misophonia. Overall quality of life (QoL) in misophonics was evaluated by the Medical Outcomes Study SF-36 health survey. The quality of sexual life (QoSL) in female misophonics was assessed by using the Sexual Quality of Life-Female self-report questionnaire. In male misophonics the QoSL was evaluated by the 11-item Sexual Quality of Life-Male self-report questionnaire. Results. Hyperacusis was diagnosed in 209 subjects (72.8%) with sound hypersensitivity while normal audiometric parameters were registered in 78 individuals (27.2%). Audiological testing with subsequent otolaryngologist counseling let us separate misophonics from people with other hearing disorders. We noted that QoL in misophoics was statistically lower than conventional baseline for healthy people. The biggest differences were registered in “Role limitations – emotional problems”, “Emotional wellbeing” and “Social functioning” items. Parameters that characterized QoSL in misophonia sufferers both sexes were statistically lower than in their healthy peers. We created an algorithm for management of individuals with misophonia that allows to separate them clearly among the subjects with sound hypersensitivity. Conclusions. The proposed own algorithm of management can be a helpful tool for doctors in different specialties to provide proper care. Considering the negative influence of misophonia on the quality of sexual life in misophonics, urologists/gynecologists and sexologists should be included into the multidisciplinary team for correct medical support of misophonics.
Key words: misophonia, algorithm, triggers, quality of sexual life, hyperacusis, audiometry
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