IMF Statement on the WHO Decision Regarding Misophonia

IMF Statement on the WHO Decision Regarding Misophonia

   Updates    October 30, 2026  |  0

COLUMBIA, Mo., October 30, 2026 — The International Misophonia Foundation (IMF) is disappointed by the World Health Organization’s response to the proposal to add misophonia to the International Classification of Diseases (ICD-11). On August 25, 2026, the WHO’s Medical and Scientific Advisory Committee (MSAC) recommended rejecting the proposal as premature.

MSAC gave three reasons. The 2022 consensus definition of misophonia drew a critical commentary in the same issue of Frontiers in Neuroscience. Diagnostic criteria have not yet been validated, and agreement on how misophonia differs from hyperacusis, phonophobia, tinnitus, migraine and autism spectrum disorder has not been documented with the relevant medical specialties.

We want to be clear with our community about what this decision says. The WHO did not find that misophonia is not real; it found that the evidence is not yet ready for classification. That is a real setback, and it is also a specific account of what the science must show next, which IMF intends to help build.

How the WHO decides what enters the ICD

The ICD is the WHO’s global standard for recording diseases, health conditions and causes of death. ICD-11 took effect in January 2022 and is now updated through proposals submitted to a public online platform.

A proposal moves through four stages:

  1. Submission. Anyone with a registered account can propose a new entry or a change on the ICD-11 Maintenance Platform. Others can read it, comment, and register agreement or disagreement.
  2. Scientific review. MSAC, a small committee of experts selected by the WHO, advises on the scientific content of the ICD and reviews the evidence behind each proposal.
  3. Classification review. The Classification and Statistics Advisory Committee (CSAC) considers how a change fits the classification, votes on proposals, and makes its recommendations to the WHO.
  4. Release. Approved changes are added in a later release. Minor updates come out each year, and major structural changes follow a longer cycle.

The volume is large. The WHO network has processed more than 17,000 ICD-11 proposals, and MSAC issued recommendations on 56 proposals in 2023 alone.

Why proposals like this are declined

Classification committees ask a narrow question: can clinicians in any country identify this condition consistently, and tell it apart from conditions that look similar? A condition can be real, common and disabling and still fall short of that test on the current evidence.

The proposal asked for misophonia to be listed under “Symptoms, signs or clinical findings of the nervous system.” As an initial step, it did not ask for misophonia to be classified as a disorder within any one specialty’s chapter. Even that cautious entry requires agreed criteria and documented boundaries with neighboring conditions.

IMF respectfully disagrees with part of MSAC’s reasoning. Published commentary is how science refines a definition; it is not evidence against a condition. The 2022 consensus definition was developed by an expert committee spanning audiology, neuroscience, psychology and psychiatry, and the field has since grown to roughly 400 published papers.

We do agree with MSAC on one point. Validated diagnostic criteria and documented agreement across specialties on differential diagnosis would strengthen any future proposal, and that work is now the priority.

What this means for people living with misophonia

Day to day, little changes immediately. Misophonia was not in the ICD before this decision, and clinicians who treat it today can continue to do so. The decision does not mean your symptoms are imagined, and it does not mean help is out of reach.

The cost lies in what recognition would have unlocked. A dedicated code would make misophonia easier to diagnose, record and study, and over time easier to cover through insurance. Without one, clinicians often document related symptoms or co-occurring conditions, coverage stays uneven, and requests for school and workplace accommodations must rest on describing impairment rather than citing a recognized diagnosis.

For clinicians and researchers, MSAC’s response names the evidence that matters most: validated diagnostic criteria, studies that separate misophonia from hyperacusis, phonophobia, tinnitus, migraine and autism, and published agreement across audiology, neurology and psychiatry.

If you are looking for care now, the IMF Clinician Directory lists clinicians who work with misophonia.

Thank you to those who brought this proposal forward

IMF thanks Dr. M. Zachary Rosenthal of the Duke Center for Misophonia and Emotion Regulation, who led the proposal, and the multidisciplinary workgroup behind it. That group brought together people with misophonia, their loved ones, scientists and clinicians, and carried the proposal through the WHO’s review.

What comes next: our DSM proposal

IMF is preparing a proposal to the American Psychiatric Association to add misophonia to Section III of the DSM-5-TR, “Conditions for Further Study.” Section III exists for conditions with proposed criteria that need further research before full recognition, which closely matches where MSAC says misophonia stands today.

MSAC’s response gives the field a clear list of what is missing, and we will use it to guide this work. A Section III listing would give researchers a shared set of criteria to test, which is exactly the evidence any future ICD proposal will need.

This work depends on the support of our community. Here is how you can help:

About The International Misophonia Foundation

The International Misophonia Foundation is a 501(c)(3) nonprofit incorporated in Missouri. IMF supports misophonia research, maintains a clinician directory, and advocates for the formal recognition of misophonia in diagnostic manuals. Learn more at misophoniafoundation.com.

References

The International Misophonia Foundation is a 501(c)(3) nonprofit. We are incorporated in Missouri. Our EIN is 93-2017604