Prevalence of misophonia in the general population and those with complaints of tinnitus: An epidemiological study

Objective Misophonia is characterized by strong emotional and physiological reactions to specific trigger sounds, while tinnitus involves the perception of sound in the absence of an external source. Although both conditions share underlying auditory-limbic mechanisms, their coexistence has not been widely studied in large-scale populations. This study aimed to estimate the prevalence and severity of misophonia among adults with normal hearing and those with tinnitus in India and to examine demographic and clinical correlates. Design/Study sample A descriptive cross-sectional survey was conducted among 10,500 participants recruited across India, including 10,000 adults with normal hearing (6,073 males, 3,927 females; mean age 39.3 ± 4.7 years) and 500 individuals with tinnitus (365 males, 135 females; mean age 42.6 ± 6.9 years). Participants completed the Amsterdam Misophonia Questionnaire (A-MISO-S), Selective Sound Sensitivity Syndrome Scale (S-Five), Tinnitus Handicap Inventory (THI), and Tinnitus Case History Questionnaire (TCHSQ). Results Misophonia was identified in 26% of the normal-hearing group and 17% of the tinnitus group. Among normal-hearing individuals, 66% exhibited mild, 24% moderate, and 10% severe symptoms, whereas tinnitus participants showed higher severity, with 23% mild, 44% moderate, and 33% severe. Misophonia prevalence was higher in females, urban residents, and those with higher education levels. A strong positive correlation (r = 0.83, p < 0.01) was found between THI and A-MISO-S scores, indicating that greater tinnitus-related distress was associated with more severe misophonic symptoms. Conclusions These findings provide large-scale evidence that misophonia and tinnitus frequently co-occur and may share overlapping neural mechanisms, underscoring the importance of integrated audiological and psychological assessment in clinical practice.