Misophonia in adolescents: clinical correlates and associations with autism-related behavioral characteristics within a clinical context

Misophonia is characterized by intense emotional and behavioral reactions to specific sounds and has been associated with psychiatric symptoms and sensory sensitivity. This study investigated the prevalence of misophonia in a clinical adolescent outpatient sample and examined its associations with psychiatric symptoms and autism-related behavioral characteristics. The study included 200 adolescents aged 12–18 years who were referred to a child and adolescent psychiatry outpatient clinic. Psychiatric diagnoses were assessed using the Kiddie Schedule for Affective Disorders and Schizophrenia for School-Age Children—Present and Lifetime Version for DSM-5. Misophonia severity was evaluated with the Amsterdam Misophonia Scale–Revised, while emotional-behavioral problems and autism-related behavioral characteristics were assessed using the Youth Self-Report/11–18. Group comparisons were performed using the chi-squared test, Fisher’s exact test, and the Mann–Whitney U test. Spearman’s correlation analyses and hierarchical logistic regression analyses were conducted. Adolescents with misophonia had higher rates of major depressive disorder. They also had significantly higher internalizing and externalizing symptoms and elevated autism-related behavioral characteristics than those without misophonia (all p < 0.001; Z = -5.62, -4.59, and − 5.70, respectively). Hierarchical logistic regression analysis revealed that higher internalizing problem scores independently predicted the presence of misophonia (Nagelkerke R² = 0.226, p < 0.001; OR = 1.07). Misophonia in adolescents appears to be closely associated with broader internalizing psychopathology and emotional-behavioral difficulties within psychiatric outpatient settings. Elevated autism-related behavioral characteristics in adolescents with misophonia support further research into the relationship between misophonia and neurodevelopmental characteristics. Such research may contribute to improving clinical assessment and understanding of behavioral patterns associated with misophonia. However, study limitations and inconsistencies in the literature highlight the need for further research in this area.