Genome-Wide Association Study of Hoarding Traits

American Journal of Psychiatry, 2007

American Journal of Psychiatry, 2007

Objective: Individuals with obsessivecompulsive disorder (OCD) who have compulsive hoarding behavior are clinically different from other OCD-affected individuals. The objective of this study was to determine whether there are chromosomal regions specifically linked to compulsive hoarding behavior in families with obsessive-compulsive disorder.

The Journal of clinical psychiatry, 2014

Compulsive or problematic hoarding behaviors occur in a variety of neuropsychiatric disorders, including obsessive compulsive disorder (OCD), schizophrenia, and dementia. Such behaviors have until recently been considered as a subtype of obsessive compulsive disorder (OCD), despite the fact that clinicians and researchers have long known that these symptoms often occur independently of OCD or other neuropsychiatric disorders. However, with the publication of the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), Hoarding Disorder (HD) has at long last achieved recognition as a clinical syndrome in its own right(1). Research suggests that this recognition is appropriate, despite the current trend away from disorder-specific approaches and towards crossdiagnostic approaches. HD is defined as a pattern of persistent difficulties with discarding personal possessions, even those with no clear value, because of strong desires to save along with distress or indecision about what to discard. Difficulty discarding is often, but not always, accompanied by excessive acquiring of unneeded objects, and, in the absence of intervention, leads over time to the accumulation of so many items that the space or room cannot be used for its usual purposes, and thus to substantial functional impairment(1). This definition allows for a distinction to be made between HD, where the core problem is desire to save leading to difficulty discarding, and hoarding behaviors typically seen in other neuropsychiatric disorders, where the main feature is often excessive collecting or acquiring of rubbish (e.g., cigarette butts, bottles from garbage cans, etc) or passive difficulties with discarding(2, 3). HD does co-occur with OCD, however, and there is evidence of etiological overlap between the two disorders. Nevertheless, HD occurs independently of OCD in 60-80% of cases, these disorders have different epidemiological and neurocognitive profiles, and most importantly, different treatment outcomes(4). Epidemiology of HD compared to OCD Prevalence rates of OCD are fairly stable across the lifespan, affecting approximately 2% of children, adolescents, and adults(5, 6). The age of onset varies, but for many, symptoms begin in childhood or early adolescence. Symptoms of OCD wax and wane with time, but tend to become problematic and/or distressing relatively soon after onset, and without treatment, continue at fairly consistent levels into old age. Unlike OCD, HD appears to be a progressive disorder. The overall prevalence of HD is between 2 and 4%, increasing to over 6% in individuals age 55 and older(7). Rather than waxing and waning, hoarding symptoms tend to be chronic and slowly increase over time(4). While the age of onset for hoarding symptoms is similar to that of OCD (ages HHS Public Access

Behaviour Research and Therapy, 2002

Hoarding behavior occurs frequently in obsessive-compulsive disorder (OCD). Results from previous studies suggest that individuals with OCD who have hoarding symptoms are clinically different than non-hoarders and may represent a distinct clinical group. In the present study, we compared 235 hoarding to 389 non-hoarding participants, all of whom had OCD, collected in the course of the OCD Collaborative Genetics Study. We found that, compared to non-hoarding individuals, hoarders were more likely to have symmetry obsessions and repeating, counting, and ordering compulsions; poorer insight; more severe illness; difficulty initiating or completing tasks; and indecision. Hoarders had a greater prevalence of social phobia and generalized anxiety disorder. Hoarders also had a greater prevalence of obsessive-compulsive and dependent personality disorders. Five personality traits were independently associated with hoarding: miserliness, preoccupation with details, difficulty making decisions, odd behavior or appearance, and magical thinking. Hoarding and indecision were more prevalent in the relatives of hoarding than of non-hoarding probands.

American Journal of Medical Genetics Part B: Neuropsychiatric Genetics, 2008

BMC Psychiatry

Background Hoarding symptoms are associated with functional impairment, though investigation of disability among individuals with hoarding disorder has largely focused on clutter-related impairment to home management activities and difficulties using space because of clutter. This analysis assesses disability among individuals with hoarding symptoms in multiple domains of everyday functioning, including cognition, mobility, self-care, interpersonal and community-level interactions, and home management. The magnitude of the association between hoarding and disability was compared to that of medical and psychiatric disorders with documented high disability burden, including major depressive disorder (MDD), diabetes, and chronic pain. Methods Data were cross-sectionally collected from 16,312 adult participants enrolled in an internet-based research registry, the Brain Health Registry. Pearson’s chi-square tests and multivariable logistic regression models were used to quantify the rela...

Depression and Anxiety, 2019

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.

Journal of Obsessive-Compulsive and Related Disorders, 2012

Hoarding disorder is an under-recognized yet complex and pervasive psychological problem that dominates individual's time, living spaces, relationships and safety. Hoarding behaviors have been associated with a number of disorders, including Obsessive-Compulsive Disorder (OCD), but as of yet, there has not been a systematic investigation of the presentation of hoarding phenomena across disorders. Simplywhat do individuals with hoarding actually hoard, and does that differ from objects kept by people without hoarding?

Genes, Brain and Behavior, 2008

The American Journal of Geriatric Psychiatry

Objectives-Little is known about the age-specific prevalence of hoarding and obsessive compulsive (OC) symptoms, particularly in older age groups. The objectives of this study were to estimate the age-specific prevalence, severity and relationships between hoarding and OC symptoms in males and females using a large population-based sample. Methods-We assessed the age-specific prevalence rates of hoarding disorder (HD) and obsessive compulsive disorder (OCD) in males and females (at various age ranges between 15-97 years) from the Netherlands Twins Register; n=15,194. Provisional HD and OCD diagnoses were made according to DSM-5 criteria utilizing self-report measures. We also assessed hoarding and OC symptom severity in the various age groups, and explored specific hoarding and OC symptom patterns (e.g., difficulty discarding, excessive acquisition, clutter, checking, washing, perfectionism and obsessions) with age. Results-Prevalence of provisional HD diagnoses (2.12%) increased linearly by 20% with every 5 years of age (z = 13.8, p < 0.0001) and did not differ between males and females. Provisional OCD diagnoses were most common in younger individuals and in individuals over age 65. Cooccurring OCD increased hoarding symptom severity (coefficient = 4.5, SE = 0.2, 95% CI = 4.1 to 4.9, t=22.0, p<0.0001). Difficulty discarding for HD and checking behaviors for OCD appeared to drive most of the increase in these diagnoses in older ages. Conclusions-Increased prevalence and severity of HD with age appears to be primarily driven by difficulties with discarding. Increases in OCD prevalence with older age were unexpected, and of potential clinical relevance.