DOI: 10.1192/j.eurpsy.2026.11075 ISSN: 0924-9338

Relationship Between Misophonia and Obsessive-Compulsive Disorder: Systematic Review and Meta-Analysis

C. Spallarossa, C. Figini, P. Motaghilotf, P. Politi, L. Fusar Poli

Introduction

Misophonia is a condition characterized by disproportionate emotional, behavioral, and physiological reactions to specific auditory and/or visual stimuli perceived as harmless by most people. Although not yet included in international diagnostic systems, misophonia has gained growing clinical and scientific interest. Its nosological ambiguity has hindered the understanding of associated psychiatric comorbidities. Among these, obsessive-compulsive disorder (OCD) is most frequently reported. The two conditions share features such as intrusive thoughts, heightened attention to specific stimuli, and avoidance behaviors. However, most individuals with misophonia do not meet full diagnostic criteria for OCD, suggesting that misophonia may represent a distinct yet partially overlapping psychopathological entity. This study systematically reviews and quantitatively analyzes the relationship between misophonia and OCD.

Objectives

To examine the co-occurrence and association between misophonia and OCD through a systematic review and meta-analysis, estimating both the pooled prevalence of OCD in misophonia and the correlation between the two conditions.

Methods

A systematic search of Web of Science and PsycINFO (January 2025) identified studies including individuals with misophonia and a comorbid psychiatric disorder diagnosed via clinical interview or validated scales. Of 464 screened records, 17 met inclusion criteria (total N = 1 193) (Image 1). Two random-effects meta-analyses were conducted: a prevalence analysis (k = 12) and a correlational analysis (k = 6). Heterogeneity (I 2 ) and publication bias were assessed following PRISMA guidelines.

Results

The prevalence meta-analysis (k = 12) showed an aggregated OCD prevalence of 9.2 % (95 % CI 4.7–17.4) in misophonia samples, with substantial heterogeneity. The correlational meta-analysis (k = 6) revealed a moderate positive correlation (μ = 0.389, 95 % CI 0.290–0.487, p < .001; I 2 = 64.9 %), consistent with a reliable association across studies. The 95 % prediction interval (0.184–0.594) indicates that this link is expected in future research. No publication bias was detected, supporting the robustness of results (Images 2-3).

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Image 3: Long description.

Conclusions

Current evidence supports a significant, though variable, association between misophonia and OCD, with an average correlation of moderate strength. These results reinforce the hypothesis of shared psychopathological mechanisms , possibly involving cognitive-perceptual rigidity and emotional hyper-reactivity. Clinically, obsessive-compulsive symptoms may worsen misophonia and its impact on daily life. Nevertheless, misophonia presents a unique symptom profile, suggesting it constitutes an independent though related disorder . Further studies with standardized diagnostic criteria and larger samples are needed to refine its classification and guide targeted interventions.

Disclosure of Interest

None Declared

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