Effects of cognitive behavioral therapy for misophonia: A systematic review

Abstract Background: Misophonia is a condition characterized by intense physical and emotional reactions to everyday sounds, commonly known as triggers. Despite its prevalence, with estimates suggesting that 6% to 20% of students are affected, research on effective treatments remains limited. Misophonia is believed to stem from enhanced connectivity between the limbic system and auditory structures, rather than auditory abnormalities. Comorbidities with mental disorders such as PTSD, OCD, and major depressive disorder are common. While no definitive treatment has been established, cognitive behavioral therapy (CBT) shows promise. Studies indicate that CBT can reduce distress and improve coping strategies, with significant symptom improvement reported after CBT interventions. Methods: We included randomized controlled trials, open-label studies, and pilot cases focused on misophonia, using PubMed, PsycINFO, Web of Science, and Google Scholar for our search. Non-English studies, animal research, and case reports were excluded. Data extraction covered study parameters and outcomes, and biases were evaluated using the Cochrane Collaboration method. Results: Screening 28 studies led to inclusion of six, including randomized controlled trials and an open-label study. Results show cognitive behavioral therapy (CBT) significantly reduces misophonia symptoms, with studies reporting up to 48% improvement in A-MISO-S scores and sustained benefits over time. These findings underscore CBT’s potential as a promising treatment for misophonia, though further research is needed to establish standardized protocols and long-term efficacy. Conclusion: This systematic review confirms CBT as effective for treating misophonia, highlighting its symptom reduction and quality of life improvements. Further research is needed to refine CBT protocols and explore alternative treatments.