Misophonia: Case Report

2017 ◽  
Vol 41 (S1) ◽  
pp. S644-S644 ◽  
Author(s):  
C. Vidal ◽  
L. Melo Vidal ◽  
M.J. Alvarenga Lage

IntroductionMisophonia refers to a condition in which there is a strong aversion to certain sounds, in response to it the person reports unpleasant emotional experiences and autonomic arousal.ObjectivesTo present the case of misophonia carrier and discuss diagnostic features.MethodologyCase report and literature review.ResultsFemale, 32 years old, married, two children. In anamnesis reported obsessional symptoms (Check doors and windows, concerned with order and symmetry of objects; read all that lies ahead, pull the hand two or three times on mobile) since adolescence. Also reported triggering situations of anger: intolerance to some noises and sounds, like chewing third, mobile keyboard, click the “mouse” computer, printer and rub hands. In the presence of these noises, she tries to move away, and already tried to attack physically relatives and insulting co-workers. She was treated with escitalopram and re-evaluation after thirty days, reported partial relief misophonia and reduction of obsessional symptoms.ConclusionThe condition was first described in the early 2000s by two audiologists, and has become the focus of interest in the field of psychiatry. Some reports suggest that misophonic symptoms may be part of other conditions such as Tourette's syndrome, obsessive compulsive disorder and generalized anxiety disorder. Specifically, the characteristics shared between misophonia and OCD, as the relief of discomfort associated with avoidance behaviour suggest that the condition is part of the obsessive-compulsive spectrum, which seems to happen with the case described above.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Author(s):  
Dan J. Stein

Anxiety disorders are the most prevalent of the mental disorders, and good translational models of these conditions encourage pharmacotherapy studies. This chapter discusses six randomized clinical trials that have contributed significantly to the pharmacotherapy of anxiety and related disorders, including generalized anxiety disorder, panic disorder, obsessive-compulsive disorder, and social anxiety disorder. Although any such list is necessarily incomplete, these selections may shed light on early and ongoing challenges in the field and on key advances to date. After reviewing these foundational papers, the advances they represent, and the work that they have given impetus to, the chapter closes by considering future directions in work on the pharmacotherapy of anxiety and related disorders.


2016 ◽  
Vol 33 (S1) ◽  
pp. S573-S574 ◽  
Author(s):  
S. Benavente López ◽  
N. Salgado Borrego ◽  
M.I. de la Hera Cabero ◽  
I. Oñoro Carrascal ◽  
L. Flores ◽  
...  

IntroductionSchizophrenia could be presented with obsessive thoughts or an obsessive-compulsive disorder. It is known that some antipsychotics like clozapine could cause obsessive symptoms or worsen them.Case ReportWe report the case of a 53-year-old male who was diagnosed of schizophrenia. The patient was admitted into a long-stay psychiatric unit due to the impossibility of outpatient treatment. He presented a chronic psychosis consisted in delusions of reference, grandiose religious delusions, and auditory pseudohallucinations. He often presented behavioral disturbances consisted in auto and heteroaggressive behavior, being needed the physical restraint. Various treatments were used, including clozapine, but obsessive and ruminative thoughts went worse. Because of that, clozapine dose was lowed, and it was prescribed sertraline and clomipramine. With this treatment the patient presented a considerable improvement of his symptoms, ceasing the auto and heteroaggressive behavior, presenting a better mood state, and being possible the coexistence with other patients. Psychotic symptoms did not disappeared, but the emotional and behavioral impact caused by them was lower.DiscussionThis case report shows how a patient with schizophrenia could present severe behavioral disturbances due to obsessive symptoms. If obsessive symptoms are presented, clozapine must be at the minimum effective dose and antidepressants with a good antiobsessive profile.ConclusionsObsessive symptoms could be presented as a part of schizophrenia. Clozapine could worsen this symptoms and it is necessary to adjust its dose to the minimum effective dose.Disclosure of interestThe authors have not supplied their declaration of competing interest.


2017 ◽  
Vol 45 ◽  
pp. 139-153 ◽  
Author(s):  
X. Sun ◽  
C. Zhu ◽  
S.H.W. So

AbstractBackground:Dysfunctions in metacognition have been reported in individuals with anxiety disorders. Although recent studies have examined metacognition in other disorders, how dysfunctional metacognition compares across disorders is not clear. This review aimed to ascertain the importance of dysfunctional metacognition in various psychopathologies, and to identify similarities and differences in metacognitive profiles across disorders.Methods:Forty-seven studies were selected from 586 articles published between 1990 and August 2015, including a total sample of 3772 patients and 3376 healthy individuals. Studies that measured metacognition using the Meta-Cognitions Questionnaire (MCQ) and its variants were included. We conducted five meta-analyses including 49 to 55 effect sizes, comparing psychiatric patients to healthy individuals on respective metacognitive dimensions of the MCQ.Results:We found elevated metacognitive dysfunctions in patients, as a group, on all MCQ dimensions. Group effects were large and robust for the two negative beliefs (i.e., beliefs about the uncontrollability and danger of thoughts, and beliefs about the need to control thoughts), and moderate and unstable for the positive beliefs. Patients showed decreased cognitive confidence and heightened cognitive self-consciousness on moderate to large levels. Moderator analyses revealed that negative beliefs about uncontrollability and danger of thoughts were most prevalent in generalized anxiety disorder, whereas heightened cognitive self-consciousness was more characteristic in obsessive-compulsive disorder. Generalized anxiety disorder, obsessive-compulsive disorder and eating disorders manifested more similar metacognitive profiles than other disorders.Conclusions:Our findings supported dysfunctional metacognition as common processes across psychopathologies, with certain dimensions being more prevalent in particular disorders.


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