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Psychiatry

Hoarding: A meta‐analysis of age of onset

Profile image of Melissa GonzalezMelissa Gonzalez

2019, Depression and Anxiety

https://doi.org/10.1002/DA.22896
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Abstract

Hoarding disorder is present in 2-6% of the population and can have an immense impact on the lives of patients and their families. Before its inclusion the Diagnostic and Statistical Manual of Mental Disorders, 5th edition, pathological hoarding was often characterized as a symptom of obsessive-compulsive disorder, and several different diagnostic assessment methods were used to identify and characterize it. Although the age of onset of pathological hoarding is an important epidemiological measure, as clarifying the age of onset of hoarding symptoms may allow for early identification and implementation of evidence-based treatments before symptoms become clinically significant, the typical age of onset of hoarding is still uncertain. To that end, this study is a systematic review and meta-analysis of research published in English between the years 1900 and 2016 containing information on age of onset of hoarding symptoms. Twenty-five studies met inclusion criteria. The mean age of onset of hoarding symptoms across studies was 16.7 years old, with evidence of a bimodal distribution of onset. The authors conclude by discussing practice implications for early identification and treatment.

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A Study on the Prevalence and Phenomenology of Hoarding in Patients with Obsessive Compulsive Disorder
riteeka dikshit

JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH, 2019

Introduction: Hoarding behaviour is a common symptom seen in patients with Obsessive Compulsive Disorder (OCD). The phenomenology and prevalence of hoarding in OCD have been under studied in India and the phenomenon is less explored on routine clinical examination. Aim: To study the prevalence and phenomenology of hoarding as a symptom in patients with OCD and tried to elucidate some differences between OCD patients with and without hoarding symptoms. Materials and Methods: A total of 50 patients with OCD and 50 relatives of psychiatric patients were the subjects for the study. The OCD group was administered the Yale Brown Obsessive Compulsive Scale (YBOCS), the Hoarding Rating Scale and the Clutter Image Rating Scale. The 50 cases of OCD were further divided on the presence and absence of hoarding as a symptom into 2 groups and the scores on the scales used were statistically analysed using descriptive statistics like frequency and percentages, chi-square test and unpaired t-test. Results: The mean duration of illness was 8.01±5.17 years and the mean age of onset of the illness was 27.28±7.11 years for all patients with OCD. OCD patients with hoarding had a shorter total duration of illness than those without hoarding. Newspapers and scrap were hoarded the most with sentimental reasons along with importance of goods were cited as reasons for the behaviour. The two groups showed significant differences on compulsive sub scale of the YBOCS and no differences were noted in the other scales used. Conclusion: Patients having OCD with hoarding as one of the symptoms may differ from those not having hoarding. However larger studies across diverse groups are needed to corroborate these findings.

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Clinical features of obsessive-compulsive disorder with hoarding symptoms: A multicenter study
Albina Torres

Journal of Psychiatric Research, 2012

Background: Factor analyses indicate that hoarding symptoms constitute a distinctive dimension of obsessive-compulsive disorder (OCD), usually associated with higher severity and limited insight. The aim was to compare demographic and clinical features of OCD patients with and without hoarding symptoms. Method: A cross sectional study was conducted with 1001 DSM-IV OCD patients from the Brazilian Research Consortium of Obsessive-Compulsive Spectrum Disorders (CTOC), using several instruments. The presence and severity of hoarding symptoms were determined using the Dimensional Yale-Brown Obsessive-Compulsive Scale. Statistical univariate analyses comparing factors possibly associated with hoarding symptoms were conducted, followed by logistic regression to adjust the results for possible confounders. Results: Approximately half of the sample (52.7%, n ¼ 528) presented hoarding symptoms, but only four patients presented solely the hoarding dimension. Hoarding was the least severe dimension in the total sample (mean score: 3.89). The most common lifetime hoarding symptom was the obsessive thought of needing to collect and keep things for the future (44.0%, n ¼ 440). After logistic regression, the following variables remained independently associated with hoarding symptoms: being older, living alone, earlier age of symptoms onset, insidious onset of obsessions, higher anxiety scores, poorer insight and higher frequency of the symmetry-ordering symptom dimension. Concerning comorbidities, major depressive, posttraumatic stress and attention deficit/hyperactivity disorders, compulsive buying and tic disorders remained associated with the hoarding dimension. Conclusion: OCD hoarding patients are more likely to present certain clinical features, but further studies are needed to determine whether OCD patients with hoarding symptoms constitute an etiologically discrete subgroup.

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How to cite TSpace items Always cite the published version, so the author(s) will receive recognition through services that track citation counts, e.g. Scopus. If you need to cite the page number of the author manuscript from TSpace because you cannot access the published version, then cite the TSpace version in addition to the published version using the permanent URI (handle) found on the record page. This article was made openly accessible by U of T Faculty. Please tell us how this access benefits you. Your story matters. Hoarding in a Community Pediatric Sample Clinical Correlates of Hoarding with and without Comorbid Obsessive-Compulsive Symptoms in a Community Pediatric Sample

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Measurement of compulsive hoarding: saving inventory-revised
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Four studies examined a new measure of compulsive hoarding (Saving Inventory-Revised; SI-R). Factor analysis using 139 hoarding participants identified 3 factors: difficulty discarding, excessive clutter, and excessive acquisition. Additional studies were conducted with hoarding participants, OCD participants without hoarding, community controls and an elderly sample exhibiting a range of hoarding behavior. Internal consistencies and test-retest reliabilities were good. The SI-R distinguished hoarding participants from all other non-hoarding comparison groups. The SI-R showed strong correlations with other indices and methods of measuring hoarding (beliefs, activity dysfunction from clutter, observer ratings of clutter in the home) and relatively weaker correlations with non-hoarding measures (positive and negative affect and OCD symptoms). The SI-R appears to be an appropriate instrument for assessing symptoms of compulsive hoarding in clinical and non-clinical samples. #

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Although compulsive hoarding appears to be a chronic, progressive disorder, little is known about its onset and course. The current study employed retrospective assessment of 51 individuals with compulsive hoarding difficulties to determine onset of various hoarding symptoms (clutter, acquisition, difficulty discarding), as well as the individual's degree of recognition of the problem at various times throughout his or her life. Participants were asked to describe life events from each decade that occurred at the time hoarding symptoms were developing. Symptoms of clutter and difficulty discarding appeared to begin at approximately the same age, whereas acquiring problems began slightly later. Recognition of the problem developed significantly later than any of the symptoms themselves. A portion of participants reported that their hoarding symptoms were reduced at some point in their lives, but few reported full remission of hoarding at any point. Survival analysis of age of onset of hoarding symptoms indicated that individuals who reported a stressful event when saving behavior started had a significantly later age of onset than those who reported no events at the age of onset. Perhaps for some individuals compulsive hoarding is a lifelong characterological phenomenon, whereas for others hoarding behavior develops later as a reaction to stress or loss. #

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    Suzanne Chabaud

    Children Australia, 2020

    We are delighted to introduce this Special Issue on 'Hoarding and Children' for the journal Children Australia. To our knowledge, this is the first time a special issue of a journal has been dedicated to this vital topic which includes a collection of articles and reflections representing comprehensive literature reviews and data-driven studies, as well as perspectives from a multitude of constituencies and stakeholders. Hoarding disorder (HD) was first defined as the 'acquisition of and failure to discard possessions that appear to be useless or of limited value' (p. 367) by Frost and Gross (1993). Since then, it has been added to the Diagnostic Statistical Manual, 5 th edition (DSM-5; American Psychiatric Association, 2013) as a distinct disorder under the umbrella of obsessive-compulsive and related disorders. The prevalence rate of hoarding is 2%-5% of the population (Iervolino et al., 2009; Samuels et al., 2008) and its impact is even greater, negatively affecting individuals with HD, their children and other family members some of whom live in the home, neighbours and the broader community. Hoarding is associated with family strain, social isolation, occupational and financial difficulties, housing instability, the worsening of health conditions, safety risks (e.g., falls, fire hazards) and could result in the removal of children and elders from the home (

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    The Neurobiological Underpinnings of Obsessive-Compulsive Symptoms in Psychosis, Translational Issues for Treatment-Resistant Schizophrenia
    Andrea de Bartolomeis

    Biomolecules

    Almost 25% of schizophrenia patients suffer from obsessive-compulsive symptoms (OCS) considered a transdiagnostic clinical continuum. The presence of symptoms pertaining to both schizophrenia and obsessive-compulsive disorder (OCD) may complicate pharmacological treatment and could contribute to lack or poor response to the therapy. Despite the clinical relevance, no reviews have been recently published on the possible neurobiological underpinnings of this comorbidity, which is still unclear. An integrative view exploring this topic should take into account the following aspects: (i) the implication for glutamate, dopamine, and serotonin neurotransmission as demonstrated by genetic findings; (ii) the growing neuroimaging evidence of the common brain regions and dysfunctional circuits involved in both diseases; (iii) the pharmacological modulation of dopaminergic, serotoninergic, and glutamatergic systems as current therapeutic strategies in schizophrenia OCS; (iv) the recent discove...

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