Hoarding in obsessive–compulsive disorder: Results from the OCD Collaborative Genetics Study

Samuels, Jack; Bienvenu, O. Joseph; Pinto, Anthony; Fyer, Abby J.; McCracken, James T.; Rauch, Scott L.; Murphy, Dennis L.; Grados, Marco A.; Greenberg, Benjamin D.; Knowles, James A.; Piacentini, John; Cannistraro, Paul A.; Cullen, Bernadette; Riddle, Mark A.; Rasmussen, Steven A.; Pauls, David L.; Willour, Virginia L.; Shugart, Yin Yao; Liang, Kung‐Yee; Hoehn‐Saric, Rudolf; Nestadt, Gerald

doi:10.1016/j.brat.2006.05.008

Cited by 189 publications

(149 citation statements)

References 49 publications

Supporting

Mentioning

125

Contrasting

Unclassified

Order By: Relevance

“…In many of the larger studies of compulsive hoarding (LaSalle-Ricci et al, 2006;Mataix-Cols et al, 1999;Samuels et al, 2006;Saxena et al, 2002), participants were selected from OCD clinics or research programs. However, as noted above, when recruitment is specifically aimed at individuals who hoard, only a minority of participants meet criteria for OCD (Frost, Steketee, Tolin, & Brown, 2006).…”

Section: Methodsmentioning

confidence: 99%

An open trial of cognitive-behavioral therapy for compulsive hoarding

Tolin

Frost

Steketee

2007

Behaviour Research and Therapy

205

151

View full text Add to dashboard Cite

The aim of the present study was to provide preliminary data on the efficacy of a new cognitivebehavioral treatment (CBT) for compulsive hoarding. Fourteen adults with compulsive hoarding (10 treatment completers) were seen in two specialty CBT clinics. Participants were included if they met research criteria for compulsive hoarding according to a semistructured interview, were age 18 or above, considered hoarding their main psychiatric problem, and were not receiving mental health treatment. Patients received 26 individual sessions of CBT, including frequent home visits, over a 7-12 month period between December 2003-February 2005. Primary outcome measures were the Saving Inventory-Revised (SI-R), Clutter Image Rating (CIR), and Clinician's Global Impression (CGI). Significant decreases from pre-to post-treatment were noted on the SI-R and CIR, but not the CGI-severity rating. CGI-Improvement ratings indicated that at mid-treatment, 40% (n = 4) of treatment completers were rated "much improved" or "very much improved;" at post-treatment, 50% (n = 5) received this rating. Adherence to homework assignments was strongly related to symptom improvement. CBT with specialized components to address problems with motivation, organizing, acquiring and removing clutter appears to be a promising intervention for compulsive hoarding, a condition traditionally thought to be resistant to treatment.

show abstract

Section: Methodsmentioning

confidence: 99%

An open trial of cognitive-behavioral therapy for compulsive hoarding

Tolin

Frost

Steketee

2007

Behaviour Research and Therapy

205

151

View full text Add to dashboard Cite

show abstract

“…These differences include greater severity of OCD, as measured by the Yale-Brown Obsessive Compulsive Scale (YBOCS) (Goodman et al, 1989); higher scores on measures of general psychopathology, anxiety, and depression; greater prevalence of social phobia and generalized anxiety disorder; and higher levels of family and social disability (Frost, Krause, & Steketee, 1996;Samuels et al, 2002;. In addition, hoarding individuals have a greater prevalence of personality disorders, especially schizotypal, dependent, avoidant, and obsessive-compulsive (Frost, Steketee, Williams, & Warren, 2000;Mataix-Cols, Baer, Rauch, & Jenike, 2000;Samuels et al, 2007a). Moreover, OCD patients with hoarding behavior often have poorer insight into their symptoms and can be less responsive to treatment with serotoninreuptake inhibitiors or cognitive-behavioral therapy than other OCD patients (Winsberg, Cassic & Koran, 1999;Black et al, 1998;Mataix-Cols et al, 1999;Mataix-Cols et al, 2002;Saxena et al, 2002).…”

Section: Nih-pa Author Manuscriptmentioning

confidence: 99%

“…In contrast, in the 184 men with OCD, the only differences were greater prevalences of social phobia and symmetry obsessions in those with, compared to those without, hoarding. To our knowledge, this is the first report of sexspecific correlates of hoarding behavior in OCD.Previously, in the OCD Collaborative Genetics Study sample, we compared OCD-affected individuals with and without hoarding behavior, but we did not investigate clinical differences separately in men and women (Samuels et al, 2007a). The aim of the current study was to determine if correlates of hoarding were different in men and women with OCD in this sample.…”

mentioning

confidence: 93%

See 1 more Smart Citation

Sex-specific clinical correlates of hoarding in obsessive-compulsive disorder

Samuels

Bienvenu

Pinto

et al. 2008

Behaviour Research and Therapy

Self Cite

View full text Add to dashboard Cite

Little is known about whether the clinical correlates of hoarding behavior are different in men and women with obsessive-compulsive disorder (OCD). In the current study, we evaluated the association of hoarding with categories of obsessions and compulsions, psychiatric disorders, personality dimensions, and other clinical characteristics separately in 151 men and 358 women with OCD who were examined during the OCD Collaborative Genetics Study. We found that, among men but not women, hoarding was associated with aggressive, sexual, and religious obsessions and checking compulsions. In men, hoarding was associated with generalized anxiety disorder and tics whereas, among women, hoarding was associated with social phobia, post-traumatic stress disorder, body dysmorphic disorder, nail biting, and skin picking. In women but not men, hoarding was associated with schizotypal and dependent personality disorder dimensions, and with low conscientiousness. These findings indicate that specific clinical correlates of hoarding in OCD are different in men and women and may reflect sex-specific differences in the course, expression, and/or etiology of hoarding behavior in OCD. KeywordsObsessive-compulsive disorder; hoarding; comorbidity; personality disorders; personality; sex differences *Corresponding author: Jack Samuels, Ph.D., Department of Psychiatry and Behavioral Sciences, Johns Hopkins, University School of Medicine, 600 N. Wolfe Street, Meyer 4-181, Baltimore, MD 21287-7228. Phone: 410-614-4942; Fax: 410-614-8137, E-mail address: jacks@jhmi.edu. NIH Public Access NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author ManuscriptHoarding behavior has been called "pathological collecting" and is characterized by the acquisition of, and unwillingness or inability to discard, large quantities of seemingly useless objects (Greenberg, Witztum & Levy, 1990;Frost & Gross, 1993). The behavior can lead to significantly cluttered living space in the home and can cause considerable distress and impairment in functioning for individuals and their family members (Tolin et al., 2008). The clutter may interfere with the normal use of space for basic household activities and increase the risk of injuries due to fire and falling, and illnesses due to poor sanitation, as well as legal citations and evictions from home by public health authorities . Although hoarding behavior can occur in several psychiatric conditions, including dementia, mental retardation, schizophrenia, and eating disorders (Damecour & Charron, 1998), it appears to occur most frequently in the context of obsessive-compulsive disorder (OCD), presenting in 20-30% or more of patients with this condition (Rasmussen & Eisen, 1992; Frost, Krause, & Steketee, 1996).Over the past decade, considerable evidence has accumulated that OCD-affected individuals with hoarding behavior show clinical differences from those without hoarding behavior. These differences include greater severity of OCD, as measured by the Yale-Brown Obsessive Compulsive Scale (YBOCS) (Goo...

show abstract

“…Compulsive hoarders have a high prevalence of comorbid personality disorders, social phobia and pathological grooming behaviors, have reduced insight into their illness and respond poorly to conventional treatments. [1][2][3] This has motivated a substantial increase in research into this condition, including its neural correlates.…”

Section: Introductionmentioning

confidence: 99%

To discard or not to discard: the neural basis of hoarding symptoms in obsessive-compulsive disorder

et al. 2008

View full text Add to dashboard Cite

Preliminary neuroimaging studies suggest that patients with the 'compulsive hoarding syndrome' may be a neurobiologically distinct variant of obsessive-compulsive disorder (OCD) but further research is needed. A total of 29 OCD patients (13 with and 16 without prominent hoarding symptoms) and 21 healthy controls of both sexes participated in two functional magnetic resonance imaging experiments consisting of the provocation of hoarding-related and symptom-unrelated (aversive control) anxiety. In response to the hoarding-related (but not symptom-unrelated) anxiety provocation, OCD patients with prominent hoarding symptoms showed greater activation in bilateral anterior ventromedial prefrontal cortex (VMPFC) than patients without hoarding symptoms and healthy controls. In the entire patient group (n = 29), provoked anxiety was positively correlated with activation in a frontolimbic network that included the anterior VMPFC, medial temporal structures, thalamus and sensorimotor cortex. Negative correlations were observed in the left dorsal anterior cingulate gyrus, bilateral temporal cortex, bilateral dorsolateral/medial prefrontal regions, basal ganglia and parieto-occipital regions. These results were independent from the effects of age, sex, level of education, state anxiety, depression, comorbidity and use of medication. The findings are consistent with the animal and lesion literature and several landmark clinical features of compulsive hoarding, particularly decision-making difficulties. Whether the results are generalizable to hoarders who do not meet criteria for OCD remains to be investigated.

show abstract

Hoarding in obsessive–compulsive disorder: Results from the OCD Collaborative Genetics Study

Cited by 189 publications

References 49 publications

An open trial of cognitive-behavioral therapy for compulsive hoarding

An open trial of cognitive-behavioral therapy for compulsive hoarding

Sex-specific clinical correlates of hoarding in obsessive-compulsive disorder

To discard or not to discard: the neural basis of hoarding symptoms in obsessive-compulsive disorder

Contact Info

Product

Resources

About