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A Case Report on Early-Onset Misophonia in a Bangladeshi Pediatric Patient
1Department of Child and Adolescent Psychiatry, LifeSpring Consultancy Limited, Dhaka, BGD.
Insights
This case report highlights early-onset misophonia in a child, presenting with auditory and visual triggers. The condition often co-occurs with obsessive-compulsive disorder (OCD), necessitating early diagnosis and tailored treatment.
Area of Science:
- Neuroscience and Psychiatry
- Pediatric Psychology
Background:
- Misophonia, a disorder characterized by strong negative emotional responses to specific sounds, is underreported in pediatric populations.
- Early-onset misophonia can present with diverse triggers, including auditory and visual stimuli, impacting a child's daily functioning.
Observation:
- A nine-year-old boy experienced misophonia symptoms from age three, with triggers evolving from auditory (yawning, breathing) to visual (nose-scratching).
- The child exhibited compulsive behaviors, such as hand-washing, and had a family history of obsessive-compulsive disorder (OCD).
- Initial trials of sertraline, risperidone, and behavioral therapy provided minimal relief.
Findings:
- The patient was diagnosed with misophonia and emerging obsessive-compulsive disorder (OCD).
- A comprehensive treatment approach combining selective serotonin reuptake inhibitors (SSRIs), cognitive behavioral therapy with exposure and response prevention (ERP), and relaxation techniques proved effective.
- This case demonstrates the significant overlap between misophonia and OCD in children.
Implications:
- Early identification and diagnosis of misophonia in children are crucial, especially when co-occurring with conditions like OCD.
- Individualized and ongoing treatment strategies are essential for managing pediatric misophonia and its comorbidities.
- This report emphasizes the need for increased awareness and research into early-onset misophonia and its complex presentation.
Abstract:
This case report describes a nine-year-old Bangladeshi boy with misophonia symptoms beginning at three years old, an underreported condition in children. He exhibited strong emotional reactions to specific sounds made by his mother, such as yawning and breathing, which later extended to visual triggers, including her nose-scratching. He attempted to stop these triggers through physical actions. Autism was ruled out. A brief trial of sertraline, risperidone, and behavioral therapy showed minimal benefit and was discontinued. In the fifth year, compulsive hand-washing emerged. Family history revealed parental OCD. On reevaluation, he was diagnosed with misophonia and emerging OCD. Treatment included selective serotonin reuptake inhibitors, cognitive behavioral therapy with exposure and response prevention, relaxation techniques, and follow-up. This case underscores the potential for early-onset misophonia with auditory and visual triggers, its overlap with OCD, and the need for early diagnosis, attention to comorbidities, and individualized, ongoing care.
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