![]() In Spain, a strict lockdown of 47 million people was put into place from March 14 to June 21, 2020, and limited the free movement of citizens to essential acts such as the acquisition of food and medicine or going to medical centers or the workplace, resulting in the confinement of the population in their places of residence. ![]() However, Spain had no choice but to implement strict confinement measures to put a halt to the dramatic spread of the disease through its population and to prevent its health system reaching saturation point. Added to this are the loss of loved ones and associated grieving processes, as well as the impacts of a sudden health and socioeconomic crisis of unprecedented magnitude.Įven before the COVID-19 pandemic, studies warned that confinement responding to outbreaks of viral diseases such as SARS and H1N1 flu produced negative psychological effects ( 3). These have been attributed to confinement, as well as the direct and indirect effects of the illness itself ( 2, 3). Since the WHO declared the COVID-19 outbreak a pandemic on Ma( 1) an increasing number of scientific reports have documented the psychological affects upon the population. Introduction COVID-19, Confinement and Secondary Impact of COVID-19 Pandemic Improved knowledge of this disorder would help address the current lack of health and social care, hopefully preventing this shortfall's impact on social and affective relationships, which are particulary important for well-being now and in the coming periods of physical distancing measures. ![]() Finally, the article gives recommendations for better management of misophonia. A semi-structured interview revealed the exceptional nature of the situations, increased hyper-sensorial sensitivity, fear of being infected with or dying from COVID-19, the patients' coping strategies, and the difficulties and constraints they faced. Most importantly, imagined or evoked triggering sounds, as well as real ones, were enough to cause the aversive responses, as displayed by the increased loss of cardiac coherence with respect to the at-rest basal level. ![]() Loss of cardiac coherence worsened with the severity of the misophonia. Despite the limited sample size, sex differences were observed in the incidence. Loss of cardiac coherence in their responses to these auditory stimuli (triggering mouth, nose and other sounds), as well as to non-triggering mouth, nose and other sounds was increased when compared to two assessments performed during the previous year. Certain auditory stimuli triggered adverse responses, lowered HRV scores, and an increased stress level and heart rate. Long-term biomonitoring of their heart variability rate (HRV) enabled to identify a significant increase in physiological arousal after the confinement period, which had already been recorded in a loss of cardiac coherence under basal rest/relaxation conditions. The 3-month period of confinement caused general emotional maladjustment, distress, and a transitory crisis. This prospective cohort study examined the impact of strict confinement (Spain, March 14–June 21, 2020) on a sample of 24 people (16 women and eight men) who had been diagnosed with moderate to extreme misophonia and were regularly attending a medical psychology center in Barcelona. Misophonia is a condition in which hearing certain sounds triggers intense anger, disgust and even severe autonomic nervous system responses. However, strict confinement had a particular impact on people suffering from misophonia and their families. The extreme, unprecedented situations in the current COVID-19 pandemic are risk factors for psychosocial stress for the entire population. 3Institut de Neurociències, Universitat Autònoma de Barcelona, Barcelona, Spain.2Department of Psychiatry and Forensic Medicine, Faculty of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain.1Centro Médico Psicológico L'Alfatier, Barcelona, Spain.Antonia Ferrer-Torres 1,2 * and Lydia Giménez-Llort 1,2,3
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