Prevalence of misophonia in patients with bipolar disorder: its relationship with autism spectrum symptoms and emotion regulation skills in comparison to a control group.

Introduction: The aim of this study is to determine the prevalence of misophonia in patients diagnosed with bipolar disorder (BD), examine its relationship with autism spectrum symptoms and emotion regulation skills, and compare it with a healthy control group.

Methods: The study included 105 patients diagnosed with BD in remission for at least three months and 105 age-, gender-, and education-matched healthy controls. All participants completed the sociodemographic data form, Hamilton Depression Rating Scale, Young Mania Rating Scale, Revised Amsterdam Misophonia Scale, Emotion Regulation Skills Questionnaire, and Autism Spectrum Quotient.

Results: Misophonia symptoms were statistically significantly more prevalent in the healthy control group (63.8%) than in the BD group (48.6%) (p = 0.026). Among BD patients with misophonia symptoms, a history of suicide attempts and higher autistic traits were statistically significantly more common (p = 0.026, p = 0.003, respectively). No statistically significant relationship was found between the severity of misophonia and autism traits (r = 0.200; p = 0.159) or emotion regulation skills (r = -0.178; p = 0.210). Multivariate regression analyses identified suicide attempt history and autistic traits as significant predictors of misophonia severity.

Conclusion: Misophonia symptoms were more prevalent in control group, contrary to our hypothesis. BD patients exhibited pronounced emotion regulation deficits, which worsened with increased autistic traits. Misophonia symptoms were statistically significantly associated with adverse psychiatric outcomes in BD patients. These findings highlight the importance of assessing misophonia, emotion regulation, and autistic traits collectively in clinical settings, and suggest that addressing misophonia symptoms in treatment planning may enhance patient functioning.