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Crowley JJ. Genomics of Obsessive-Compulsive Disorder and Related Disorders: What the Clinician Needs to Know. Psychiatr Clin North Am 2023; 46:39-51. [PMID: 36740354 DOI: 10.1016/j.psc.2022.11.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
A wealth of evidence has shown that genetics plays a major role in susceptibility to obsessive-compulsive disorder (OCD) and all of its related disorders. Several large-scale, collaborative efforts using modern genomic methods are beginning to reveal the genetic architecture of these traits and identify long-sought risk genes. In this article, we summarize current OCD and related disorder genomic knowledge and explain how to communicate this information to patients and their families. The article concludes with a discussion of how genomic discovery in OCD and related disorders can inform our understanding of disease etiology and provide novel targets for therapeutic development.
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Affiliation(s)
- James J Crowley
- Department of Genetics, University of North Carolina at Chapel Hill, 120 Mason Farm Road, Chapel Hill, NC 27599, USA; Department of Psychiatry, University of North Carolina at Chapel Hill, 120 Mason Farm Road, Chapel Hill, NC 27599, USA.
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Strom NI, Smit DJA, Silzer T, Iyegbe C, Burton CL, Pool R, Lemire M, Crowley JJ, Hottenga JJ, Ivanov VZ, Larsson H, Lichtenstein P, Magnusson P, Rück C, Schachar RJ, Wu HM, Meier SM, Crosbie J, Arnold PD, Mattheisen M, Boomsma DI, Mataix-Cols D, Cath D. Meta-analysis of genome-wide association studies of hoarding symptoms in 27,537 individuals. Transl Psychiatry 2022; 12:479. [PMID: 36379924 PMCID: PMC9666541 DOI: 10.1038/s41398-022-02248-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 10/27/2022] [Accepted: 11/02/2022] [Indexed: 11/16/2022] Open
Abstract
Hoarding Disorder (HD) is a mental disorder characterized by persistent difficulties discarding or parting with possessions, often resulting in cluttered living spaces, distress, and impairment. Its etiology is largely unknown, but twin studies suggest that it is moderately heritable. In this study, we pooled phenotypic and genomic data from seven international cohorts (N = 27,537 individuals) and conducted a genome wide association study (GWAS) meta-analysis of parent- or self-reported hoarding symptoms (HS). We followed up the results with gene-based and gene-set analyses, as well as leave-one-out HS polygenic risk score (PRS) analyses. To examine a possible genetic association between hoarding symptoms and other phenotypes we conducted cross-trait PRS analyses. Though we did not report any genome-wide significant SNPs, we report heritability estimates for the twin-cohorts between 26-48%, and a SNP-heritability of 11% for an unrelated sub-cohort. Cross-trait PRS analyses showed that the genetic risk for schizophrenia and autism spectrum disorder were significantly associated with hoarding symptoms. We also found suggestive evidence for an association with educational attainment. There were no significant associations with other phenotypes previously linked to HD, such as obsessive-compulsive disorder, depression, anxiety, or attention-deficit hyperactivity disorder. To conclude, we found that HS are heritable, confirming and extending previous twin studies but we had limited power to detect any genome-wide significant loci. Much larger samples will be needed to further extend these findings and reach a "gene discovery zone". To move the field forward, future research should not only include genetic analyses of quantitative hoarding traits in larger samples, but also in samples of individuals meeting strict diagnostic criteria for HD, and more ethnically diverse samples.
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Affiliation(s)
- Nora I Strom
- Department of Psychology, Humboldt-Universität zu Berlin, Berlin, Germany.
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, LMU Munich, Munich, Germany.
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet & Stockholm Health Care Services, Region Stockholm, Sweden.
- Department of Biomedicine, Aarhus University, Aarhus, Denmark.
| | - Dirk J A Smit
- Department of Psychiatry, Amsterdam University Medical Centers, Amsterdam, The Netherlands
- Amsterdam Neuroscience, Amsterdam, The Netherlands
| | - Talisa Silzer
- Department of Psychiatry, Hospital for Sick Children, Toronto, ON, Canada
| | - Conrad Iyegbe
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, England
- Department of Genetics and Genomic Sciences, Icahn School of Medicine, Mount Sinai, New York, USA
| | - Christie L Burton
- Department of Psychiatry, Hospital for Sick Children, Toronto, ON, Canada
| | - René Pool
- Department of Biological Psychology, Vrije Universiteit, Amsterdam, Netherlands
| | - Mathieu Lemire
- Department of Psychiatry, Hospital for Sick Children, Toronto, ON, Canada
| | - James J Crowley
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet & Stockholm Health Care Services, Region Stockholm, Sweden
- Departments of Genetics and Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, USA
| | - Jouke-Jan Hottenga
- Netherlands Twin Register, Biological Psychology, Vrije Universiteit, Amsterdam, The Netherlands
| | - Volen Z Ivanov
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet & Stockholm Health Care Services, Region Stockholm, Sweden
| | - Henrik Larsson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- School of Medical sciences, Örebro University, Örebro, Sweden
| | - Paul Lichtenstein
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Patrik Magnusson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Christian Rück
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet & Stockholm Health Care Services, Region Stockholm, Sweden
| | - Russell J Schachar
- Department of Psychiatry, Hospital for Sick Children, Toronto, ON, Canada
| | - Hei Man Wu
- Department of Genetics and Genomic Sciences, Icahn School of Medicine, Mount Sinai, New York, USA
| | - Sandra M Meier
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
- Community Health & Epidemiology, Dalhousie University, NS, Dalhousie, Canada
| | - Jennifer Crosbie
- Department of Psychiatry, Hospital for Sick Children, Toronto, ON, Canada
| | - Paul D Arnold
- The Mathison Centre for Mental Health Research & Education, Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Departments of Psychiatry and Medical Genetics, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Manuel Mattheisen
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, LMU Munich, Munich, Germany
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
- Community Health & Epidemiology, Dalhousie University, NS, Dalhousie, Canada
| | - Dorret I Boomsma
- Netherlands Twin Register, Biological Psychology, Vrije Universiteit, Amsterdam, The Netherlands
- Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
- Amsterdam Reproduction and Development Research Institute, Amsterdam, The Netherlands
| | - David Mataix-Cols
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet & Stockholm Health Care Services, Region Stockholm, Sweden
| | - Danielle Cath
- Rijksuniversiteit Groningen and Department of Psychiatry, University Medical Center Groningen, Groningen, Netherlands
- Department of specialized training, Drenthe Mental Health Care Institute, Assen, The Netherlands
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Gong Y, Tan Y, Huang R. Exploring the relationship between dispositional mindfulness and hoarding behavior: A moderated multi-mediation model. Front Psychol 2022; 13:935897. [PMID: 36033020 PMCID: PMC9415804 DOI: 10.3389/fpsyg.2022.935897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Accepted: 07/29/2022] [Indexed: 11/13/2022] Open
Abstract
Hoarding behavior may not only interfere with hoarders’ daily lives but may also endanger the community. However, few studies have investigated the role of personality characteristics in hoarding behavior. We hypothesized that dispositional mindfulness would be negatively associated with hoarding behavior, and tested mechanisms and gender differences in this association. An online survey was conducted in a sample of 533 Chinese adults (262 women, Mage = 26.82; SD = 6.30). Regression-based analyses showed that mindfulness was associated with less hoarding behavior through higher self-esteem and lower emotion dysregulation. Moreover, gender moderated the mediating effect of emotion dysregulation in the association between mindfulness and hoarding behavior. Specifically, the indirect association was only significant for women. These findings provide a deeper understanding of how, why, and for whom dispositional mindfulness is negatively associated with hoarding behavior, they provide support for self-completion theory and the cognitive-behavioral model of hoarding, and they have heuristic value for future research.
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Efe A, Açıkel SB, Uygun SD, Canlı M, Temeltürk RD, Gürel Y, Çetinkaya M, Çakmak FH. A Retrospective Evaluation on Demographic, Phenomenological, and Comorbidity Features of Pediatric Obsessive-Compulsive Disorder. J Nerv Ment Dis 2022; 210:6-25. [PMID: 34417423 DOI: 10.1097/nmd.0000000000001402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
ABSTRACT The impacts of sex, age of onset, phenotype, and comorbidity on clinical features were explored in a large clinical sample with pediatric obsessive-compulsive disorder (p-OCD) (n = 457), along with concomitant specific features in the framework of different symptom dimensions/phenotypes, by a retrospective cross-sectional evaluation design. The most prevalent phenotype was obsession/checking (almost half), and the clinical features belonging to different phenotypes varied among sexes, age of onset, severity, and comorbidities. The contamination and aggressive obsessions, along with the compulsions such as cleaning and repeating routine activities, were the most prevalent symptoms, which were prevalently accompanied by generalized anxiety disorder, attention deficit hyperactivity disorder, and depression. Females with OCD were likely prone to exhibit comorbid internalizing disorders, whereas males were prone to externalizing. This recent study on a large Turkish clinical sample of p-OCD followed up within 5 years, highlighting separate evidence on subtyping of p-OCD in phenotype and comorbidity frame.
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Affiliation(s)
- Ayşegül Efe
- Department of Child and Adolescent Psychiatry, Dr. Sami Ulus Maternity, Children's Health and Diseases Training and Research Hospital, University of Health Sciences, Ankara, Turkey
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Zakrzewski JJ, Henderson R, Archer C, Vigil OR, Mackin S, Mathews CA. Subjective cognitive complaints and objective cognitive impairment in hoarding disorder. Psychiatry Res 2022; 307:114331. [PMID: 34920395 DOI: 10.1016/j.psychres.2021.114331] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Revised: 12/03/2021] [Accepted: 12/05/2021] [Indexed: 11/24/2022]
Abstract
Individuals with Hoarding Disorder (HD) frequently complain of problems with attention and memory. These self-identified difficulties are often used as justification for saving and acquiring behaviors. Research using neuropsychological measures to examine verbal and visual memory performance and sustained attention have reported contradictory findings. Here we aim to determine the relationship between self-reported problems with memory and attention, objective memory and attention performance, and self-reported depression and anxiety symptoms in HD. Data was available for 319 individuals who participated in a treatment study of HD. Multiple regression was used to assess the relationship between self-reported complaints and objective measures, with age, education, and measures of depression and anxiety included as covariates. We found no association between self-reported memory difficulties and objective verbal or visual memory performance. Self-reported problems with attention were associated with objective attentional performance, although this relationship was partially accounted for by anxiety symptom severity. There was a small association between visual memory performance at baseline and improvements in hoardingrelated functional abilities following treatment. Improvements in subjective memory complaints pre-to-post treatment were associated with improvements in hoarding symptom severity and hoarding-related functioning. These results demonstrate a dissociation between perceived and objective functioning in HD.
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Affiliation(s)
- Jessica J Zakrzewski
- Department of Psychiatry, Center for OCD, Anxiety, and Related Disorders, College of Medicine, University of Florida, FL, United States of America.
| | - Rebecca Henderson
- Department of Psychiatry, Center for OCD, Anxiety, and Related Disorders, College of Medicine, University of Florida, FL, United States of America
| | - Christian Archer
- Department of Psychiatry, Center for OCD, Anxiety, and Related Disorders, College of Medicine, University of Florida, FL, United States of America
| | - Ofilio R Vigil
- Department of Psychiatry, University of California, San Francisco and San Francisco VA Medical Center, San Francisco, CA, United States of America
| | - Scott Mackin
- Department of Psychiatry, University of California, San Francisco and San Francisco VA Medical Center, San Francisco, CA, United States of America
| | - Carol A Mathews
- Department of Psychiatry, Center for OCD, Anxiety, and Related Disorders, College of Medicine, University of Florida, FL, United States of America
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Demaria F, Pontillo M, Tata MC, Gargiullo P, Mancini F, Vicari S. Psychoeducation focused on family accommodation: a practical intervention for parents of children and adolescents with obsessive-compulsive disorder. Ital J Pediatr 2021; 47:224. [PMID: 34742338 PMCID: PMC8572476 DOI: 10.1186/s13052-021-01177-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Accepted: 10/23/2021] [Indexed: 01/20/2023] Open
Abstract
Obsessive-compulsive disorder (OCD) is a neuropsychiatric disorder that is frequently diagnosed in children and adolescents. In pediatric OCD, family plays an important role in the development and maintenance of the disease. In this relationship, both genetic and behavioral factors, such as parental modeling and family accommodation, are significant. Parental modeling concerns the daily enactment of dysfunctional behavioral patterns by a parent with OCD, which may influence children. Family accommodation, in contrast, describes the direct participation of parents in their child's compulsive rituals, by modifying daily routines or by facilitating avoidance of OCD triggers, to decrease the child's distress and time spent executing compulsions. Approximately 80-90% of the relatives of OCD patients actively participate in patients' rituals. The literature demonstrates that a high level of family accommodation is associated with OCD symptom severity, reduced response to cognitive-behavioral treatment (CBT), and a higher risk of therapy dropout.Despite this, no studies have aimed at delineating practical guidance for psychotherapists to support parents in reducing family accommodation.The main aim of this paper is to propose a psychoeducation intervention focused on cognitive-behavioral strategies to help families to manage their child's OCD behaviors without enacting dysfunctional family accommodation behaviors in order to support their child's successful therapy.
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Affiliation(s)
- Francesco Demaria
- Child and Adolescence Neuropsychiatry Unit, Department of Neuroscience, Children Hospital Bambino Gesù, IRCCS, Viale Ferdinando Baldelli 41, 00146 Rome, Italy
| | - Maria Pontillo
- Child and Adolescence Neuropsychiatry Unit, Department of Neuroscience, Children Hospital Bambino Gesù, IRCCS, Viale Ferdinando Baldelli 41, 00146 Rome, Italy
| | - Maria Cristina Tata
- Child and Adolescence Neuropsychiatry Unit, Department of Neuroscience, Children Hospital Bambino Gesù, IRCCS, Viale Ferdinando Baldelli 41, 00146 Rome, Italy
| | - Prisca Gargiullo
- Child and Adolescence Neuropsychiatry Unit, Department of Neuroscience, Children Hospital Bambino Gesù, IRCCS, Viale Ferdinando Baldelli 41, 00146 Rome, Italy
| | - Francesco Mancini
- Scuola di Psicoterapia Cognitiva APC-SPC, Viale Castro Pretorio, 116, 00185 Rome, Italy
| | - Stefano Vicari
- Child and Adolescence Neuropsychiatry Unit, Department of Neuroscience, Children Hospital Bambino Gesù, IRCCS, Viale Ferdinando Baldelli 41, 00146 Rome, Italy
- Scuola di Psicoterapia Cognitiva APC-SPC, Viale Castro Pretorio, 116, 00185 Rome, Italy
- Department of Life Sciences and Public Health, Catholic University of the Sacred Heart, 00168 Rome, Italy
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Tolin DF, Frost RO, Steketee G, Muroff J. Cognitive Behavioral Therapy For Hoarding Disorder: A Meta-Analysis. FOCUS (AMERICAN PSYCHIATRIC PUBLISHING) 2021; 19:468-476. [PMID: 35747301 PMCID: PMC9063573 DOI: 10.1176/appi.focus.19403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/18/2014] [Revised: 09/24/2014] [Accepted: 09/27/2014] [Indexed: 06/15/2023]
Abstract
(Appeared originally in Depression and Anxiety 2015; 32:158-166).
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Affiliation(s)
- David F Tolin
- Anxiety Disorders Center, Institute of Living, Hartford, Connecticut; Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut; Department of Psychology, Smith College, Northampton, Massachusetts; School of Social Work, Boston University, Boston, Massachusetts
| | - Randy O Frost
- Anxiety Disorders Center, Institute of Living, Hartford, Connecticut; Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut; Department of Psychology, Smith College, Northampton, Massachusetts; School of Social Work, Boston University, Boston, Massachusetts
| | - Gail Steketee
- Anxiety Disorders Center, Institute of Living, Hartford, Connecticut; Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut; Department of Psychology, Smith College, Northampton, Massachusetts; School of Social Work, Boston University, Boston, Massachusetts
| | - Jordana Muroff
- Anxiety Disorders Center, Institute of Living, Hartford, Connecticut; Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut; Department of Psychology, Smith College, Northampton, Massachusetts; School of Social Work, Boston University, Boston, Massachusetts
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Pittenger C, Brennan BP, Koran L, Mathews CA, Nestadt G, Pato M, Phillips KA, Rodriguez CI, Simpson HB, Skapinakis P, Stein DJ, Storch EA. Specialty knowledge and competency standards for pharmacotherapy for adult obsessive-compulsive disorder. Psychiatry Res 2021; 300:113853. [PMID: 33975093 PMCID: PMC8536398 DOI: 10.1016/j.psychres.2021.113853] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Accepted: 03/01/2021] [Indexed: 12/12/2022]
Abstract
Obsessive-compulsive disorder (OCD) affects approximately one person in 40 and causes substantial suffering. Evidence-based treatments can benefit many; however, optimal treatment can be difficult to access. Diagnosis is frequently delayed, and pharmacological and psychotherapeutic interventions often fail to follow evidence-based guidelines. To ameliorate this distressing situation, the International OCD Accreditation Task Force of the Canadian Institute for Obsessive-Compulsive Disorders has developed knowledge and competency standards for specialized treatments for OCD through the lifespan. These are foundational to evidence-based practice and will form the basis for upcoming ATF development of certification/accreditation programs. Here, we present specialty standards for the pharmacological treatment of adult OCD. We emphasize the importance of integrating pharmacotherapy with clear diagnosis, appreciation of complicating factors, and evidence-based cognitive behavioral therapy. Clear evidence exists to inform first- and second-line pharmacological treatments. In disease refractory to these initial efforts, multiple strategies have been investigated, but the evidence is more equivocal. These standards summarize this limited evidence to give the specialist practitioner a solid basis on which to make difficult decisions in complex cases. It is hoped that further research will lead to development of a clear, multi-step treatment algorithm to support each step in clinical decision-making.
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Affiliation(s)
- Christopher Pittenger
- Department of Psychiatry and Yale Child Study Center, Yale University School of Medicine, New Haven, CT, United States.
| | - Brian P Brennan
- Biological Psychiatry Laboratory and Obsessive-Compulsive Disorder Institute, McLean Hospital, Belmont, MA, United States; Department of Psychiatry, Harvard Medical School, Boston, MA, United States
| | - Lorrin Koran
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, United States
| | - Carol A Mathews
- Department of Psychiatry, University of Florida, Gainesville, FL, United States
| | - Gerald Nestadt
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Michele Pato
- Institute for Genomic Health and Department of Psychiatry, SUNY Downstate College of Medicine, Brooklyn, NY, United States
| | - Katharine A Phillips
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, RI, and Department of Psychiatry, Weill Cornell Medical College, New York, NY, United States
| | - Carolyn I Rodriguez
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, United States; Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, United States
| | - H Blair Simpson
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, United States; Office of Mental Health, Research Foundation for Mental Hygiene, New York Psychiatric Institute, New York, NY, United States
| | - Petros Skapinakis
- Department of Psychiatry, School of Health Sciences, University of Ioannina, Ioannina, Greece
| | - Dan J Stein
- Department of Psychiatry and Neuroscience Institute, University of Cape Town, Cape Town, South Africa
| | - Eric A Storch
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, United States
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Tumkaya S, Yucens B, Mart M, Tezcan D, Kashyap H. Multifaceted impulsivity in obsessive-compulsive disorder with hoarding symptoms. Nord J Psychiatry 2021; 75:207-213. [PMID: 33146050 DOI: 10.1080/08039488.2020.1838605] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 10/07/2020] [Accepted: 10/14/2020] [Indexed: 01/17/2023]
Abstract
OBJECTIVE Hoarding is common in obsessive-compulsive disorder (OCD), and OCD with hoarding may have poorer prognostic features than OCD without hoarding. The aim of this study was to investigate the relationship between multifaceted impulsivity and hoarding symptoms in individuals with OCD. This relationship is important to be able to understand the psychopathological mechanisms of hoarding symptoms in OCD patients. METHODS The study included 136 individuals with OCD classified as OCD with high hoarding symptoms (OCDwHH, n = 41) and OCD with low/none hoarding symptoms (OCDwLH, n = 95), together with 94 healthy control subjects. All the participants completed the Hoarding Rating Scale-Interview, Barratt Impulsiveness Scale-11, Yale-Brown Obsessions and Compulsions Scale, Hamilton Depression Rating Scale, and Hamilton Anxiety Rating Scale. RESULTS The OCDwHH group had more severe anxiety (p = 0.016) and attentional impulsivity (p = 0.002) than OCDwLH. Attentional impulsivity scores were positively correlated with hoarding symptom scores (p < 0.001). Both attentional and motor impulsivity scores were positively correlated with anxiety levels (p = 0.037, p = 0.045, respectively). In partial correlation analysis, motor impulsivity was positively correlated with the severity of hoarding symptoms controlling for anxiety severity (p = 0.045). In hierarchical linear regression analysis, only attentional impulsivity predicted the severity of hoarding symptoms independently of anxiety, severity of obsessive-compulsive symptoms and motor impulsivity (β = 0.268, Adjusted R2 = 0.114, p = 0.006). CONCLUSION Attentional impulsivity is associated with hoarding symptoms in OCD. Future studies that reveal this relationship may contribute to treatment modalities for the OCD patients with hoarding symptoms.
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Affiliation(s)
- Selim Tumkaya
- Faculty of Medicine, Department of Psychiatry, Pamukkale University, Denizli, Turkey
| | - Bengu Yucens
- Faculty of Medicine, Department of Psychiatry, Pamukkale University, Denizli, Turkey
| | - Mehmet Mart
- Department of Psychiatry, Adıyaman University, Adıyaman, Turkey
| | - Didem Tezcan
- Bolu İzzet Baysal Psychiatry Hospital, Bolu, Turkey
| | - Himani Kashyap
- Department of Clinical Psychology, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bengaluru, India
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Obsessive-Compulsive Personality Disorder Co-occurring in Individuals with Obsessive-Compulsive Disorder: A Systematic Review and Meta-analysis. Harv Rev Psychiatry 2021; 29:95-107. [PMID: 33666394 DOI: 10.1097/hrp.0000000000000287] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
LEARNING OBJECTIVES After participating in this activity, learners should be better able to:• Assess the rates of co-occurring obsessive-compulsive personality disorder (OCPD) in patients with obsessive-compulsive disorder (OCD)• Identify characteristics related to OCD with co-occurring OCPD. ABSTRACT The current literature discloses discrepant findings regarding the rates of co-occurring obsessive-compulsive personality disorder (OCPD) in patients with obsessive-compulsive disorder (OCD). In addition, it is not clear which characteristics are related specifically to OCD with co-occurring OCPD. We conducted the first systematic review and meta-analysis of the studies of the prevalence of OCPD in patients with OCD. We also investigated potential moderators of the prevalence, including OCD severity, age of onset of OCD, sex, current age, methodological quality, and publication date of the studies. Electronic databases and gray literature were searched by two independent reviewers. A PRISMA systematic review with a random-effect meta-analysis was conducted. Thirty-four studies were included. A significant mean effect size of 0.25 without publication bias indicated that OCPD was present in 25% of patients with OCD, suggesting that the two conditions are distinct clinical entities. This prevalence was higher than the rates found in the literature for any other personality disorders among OCD patients. OCPD that occurs in the context of OCD was more likely to be present in males and to be characterized by a later age of onset of OCD, older age at assessment, and less severe OCD symptoms. Clinicians should consider these findings when assessing and planning treatment of OCD with co-occurring OCPD.
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Jaisoorya TS, Thamby A, Manoj L, Kumar GS, Gokul GR, Narayanaswamy JC, Arumugham SS, Thennarassu K, Reddy YCJ. Prevalence of hoarding disorder among primary care patients. BRAZILIAN JOURNAL OF PSYCHIATRY 2020; 43:168-173. [PMID: 32876135 PMCID: PMC8023159 DOI: 10.1590/1516-4446-2020-0846] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Accepted: 04/22/2020] [Indexed: 11/22/2022]
Abstract
Objectives: Despite the inclusion of hoarding disorder (HD) in the DSM-5, there is little epidemiological data on hoarding from low and middle-income countries. This study, the first from India, examines the prevalence and correlates of HD among primary care patients in the state of Kerala, India. Methods: To assess correlates, the Hoarding Rating Scale-Interview (HRS-I) and other structured instruments were administered to 7,555 subjects selected by stratified random sampling from 71 primary health centers. Results: The prevalence of HD was 1.02% (95%CI 0.8-1.3). Those with HD were more likely to be older and live alone. In the binary logistic regression analysis, after controlling for significant sociodemographic variables, subjects with HD had a higher odds of reporting chronic illness, depression, anxiety disorder, alcohol abuse, and tobacco dependence. Subjects with HD had significantly higher disability scores than unaffected individuals. Conclusion: Although HD is not uncommon in India, this disorder is rarely reported in specialty settings in India, which suggests that awareness and detection should be improved, considering the co-occurring negative correlates and disability among affected individuals.
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Affiliation(s)
- T S Jaisoorya
- National Institute of Mental Health and Neuro-Sciences (NIMHANS), Bengaluru, Karnataka, India
| | - Abel Thamby
- National Institute of Mental Health and Neuro-Sciences (NIMHANS), Bengaluru, Karnataka, India
| | - L Manoj
- National Health Mission (NHM), Thiruvananthapuram, Kerala, India
| | - G Sunil Kumar
- National Health Mission (NHM), Thiruvananthapuram, Kerala, India
| | - G R Gokul
- National Health Mission (NHM), Thiruvananthapuram, Kerala, India
| | | | - Shyam Sundar Arumugham
- National Institute of Mental Health and Neuro-Sciences (NIMHANS), Bengaluru, Karnataka, India
| | - K Thennarassu
- National Institute of Mental Health and Neuro-Sciences (NIMHANS), Bengaluru, Karnataka, India
| | - Y C Janardhan Reddy
- National Institute of Mental Health and Neuro-Sciences (NIMHANS), Bengaluru, Karnataka, India
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Ferreira EA, Paloski LH, Costa DB, Moret-Tatay C, Irigaray TQ. Psychopathological Comorbid Symptoms in Animal Hoarding Disorder. Psychiatr Q 2020; 91:853-862. [PMID: 32319042 DOI: 10.1007/s11126-020-09743-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
The main goal of this research is to describe the psychopathological symptoms comorbid to animal hoarding disorder. This is a cross-sectional study with a sample of a 33 individuals sample diagnosed with animal hoarding disorder. For data collection, a Sociodemographic Data questionnaire and a Semi-Structured Clinical Interview were used, based on the DSM-5 Level 1 Cross-Cutting Symptom Measure. The sample consisted of 24 women (72.7%) and 9 men (27.30%), with a prevalence of 64% of the elderly. The mean number of self-reported animals per residence was 41.12 (DP = 24.41), totaling 1357 animals: 915 (68%) dogs, 382 (28%) cats, and 50 (4%) ducks. The results indicated animal hoarding disorder the comorbid psychopathological symptoms of depression (36%), anxiety (36%), memory deficits (27%), mania (21%) and obsessive-compulsive disorder (18%). The analyses revealed a higher occurrence of these symptoms among participants who had hoarded animals for over 20 years.
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Affiliation(s)
- Elisa Arrienti Ferreira
- Postgraduate Program in Psychology of School of Heath and Life Sciences, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Av. Ipiranga, 6681, Building 11, 9th floor, Porto Alegre, Rio Grande do Sul, 90619-900, Brazil
| | - Luis Henrique Paloski
- Postgraduate Program in Psychology of School of Heath and Life Sciences, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Av. Ipiranga, 6681, Building 11, 9th floor, Porto Alegre, Rio Grande do Sul, 90619-900, Brazil.,Department of Psychology, Faculdade Meridional - IMED, Passo Fundo, Rio Grande do Sul, Brazil
| | - Dalton Breno Costa
- Postgraduate Program in Psychology of School of Heath and Life Sciences, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Av. Ipiranga, 6681, Building 11, 9th floor, Porto Alegre, Rio Grande do Sul, 90619-900, Brazil.,Department of Psychology, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, Rio Grande do Sul, Brazil
| | - Carmen Moret-Tatay
- MEBlab. Department of Psychology, Universidad Católica de Valencia San Vicente Mártir, Av. Ipiranga, 6681, Building 11, 9th floor, Valencia, Spain
| | - Tatiana Quarti Irigaray
- Postgraduate Program in Psychology of School of Heath and Life Sciences, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Av. Ipiranga, 6681, Building 11, 9th floor, Porto Alegre, Rio Grande do Sul, 90619-900, Brazil.
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13
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Muhlbauer JE, Ferrão YA, Eppingstall J, Albertella L, do Rosário MC, Miguel EC, Fontenelle LF. Predicting marriage and divorce in obsessive-compulsive disorder. JOURNAL OF SEX & MARITAL THERAPY 2020; 47:90-98. [PMID: 32783604 DOI: 10.1080/0092623x.2020.1804021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Single (N = 472, 51.7%), married or living in stable cohabitation (N = 375, 41.1%) and divorced or separated (N = 66, 7.2%) patients with obsessive-compulsive disorder (OCD) were compared in terms of their sociodemographic features, OCD phenotypes, and comorbidity profile. Using single status as a reference group, a multinominal regression analysis found increased age, lower severity of hoarding, increased rates of panic disorder without agoraphobia, and lower rates of dysthymic disorder to be associated with married or stable cohabitation status. Concomitantly, increased age, higher severity of symmetry symptoms, and increased rates of skin picking disorder were found to be associated with divorced status. These findings suggest that there is a relationship between marital status and different OCD phenotypes.
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Affiliation(s)
- Julia E Muhlbauer
- Obsessive, Compulsive, and Anxiety Spectrum Research Program, Institute of Psychiatry, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
| | - Ygor A Ferrão
- Department of Psychiatry, Federal University of Health Sciences of Porto Alegre (UFCSPA), Porto Alegre, Brazil
| | - Jan Eppingstall
- Turner Institute for Brain and Mental Health, Monash University, Clayton, Australia
| | - Lucy Albertella
- Turner Institute for Brain and Mental Health, Monash University, Clayton, Australia
| | - Maria C do Rosário
- Department of Psychiatry, Federal University of São Paulo (UNIFESP), São Paulo, Brazil
| | - Euripedes C Miguel
- Obsessive-Compulsive Spectrum Disorders Program (PROTOC), Department and Institute of Psychiatry, University of São Paulo (USP), São Paulo, Brazil
| | - Leonardo F Fontenelle
- Obsessive, Compulsive, and Anxiety Spectrum Research Program, Institute of Psychiatry, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
- Turner Institute for Brain and Mental Health, Monash University, Clayton, Australia
- D'Or Institute for Research and Education (IDOR), Rio de Janeiro, Brazil
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14
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Sinopoli VM, Erdman L, Burton CL, Park LS, Dupuis A, Shan J, Goodale T, Shaheen SM, Crosbie J, Schachar RJ, Arnold PD. Serotonin system genes and hoarding with and without other obsessive-compulsive traits in a population-based, pediatric sample: A genetic association study. Depress Anxiety 2020; 37:760-770. [PMID: 32092211 DOI: 10.1002/da.22996] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2019] [Revised: 11/20/2019] [Accepted: 12/17/2019] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Hoarding, originally only considered a symptom of obsessive-compulsive disorder (OCD), is now categorized as a separate disorder in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). We studied candidate serotonergic genes and the distinctness of hoarding in children and adolescents and hypothesized that unique gene variants would be associated with hoarding alone. METHODS We examined obsessive-compulsive (OC) traits, including hoarding, in a total of 5,213 pediatric participants in the community. We genotyped candidate serotonin genes (5-HTTLPR polymorphism in SLC6A4 for 2,018 individuals and single nucleotide polymorphisms [SNPs] across genes SLC6A4, HTR2A, and HTR1B for 4,711 individuals). In a previous study conducted by our group in the same sample, we identified a significant association between 5-HTTLPR and hoarding in males. In this study, we examined hoarding more closely by testing the association between serotonin gene variants and hoarding traits with and without other accompanying OC traits. RESULTS The [LG +S] variant in 5-HTTLPR was significantly associated with hoarding alone in males (p-value of 0.009). There were no significant findings for 5-HTTLPR in females. There were no significant findings after correction for multiple comparisons using SNP array data, but top SNP findings suggested that variation downstream of HTR1B may be implicated in hoarding alone in females. CONCLUSIONS Our results suggest specific serotonin gene variants are associated with hoarding traits alone, differing between sexes. Top findings are in line with our former study, suggesting that individuals with hoarding alone were driving previous results. Our paper supports hoarding disorder's new designation.
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Affiliation(s)
- Vanessa M Sinopoli
- Institute of Medical Science, University of Toronto, Toronto, ON, Canada.,Program in Genetics & Genome Biology, The Hospital for Sick Children, Toronto, ON, Canada
| | - Lauren Erdman
- Program in Genetics & Genome Biology, The Hospital for Sick Children, Toronto, ON, Canada.,Department of Computer Science, University of Toronto, Toronto, ON, Canada
| | - Christie L Burton
- Program in Genetics & Genome Biology, The Hospital for Sick Children, Toronto, ON, Canada.,Program in Neurosciences and Mental Health, The Hospital for Sick Children, Toronto, ON, Canada
| | - Laura S Park
- Institute of Medical Science, University of Toronto, Toronto, ON, Canada.,Program in Genetics & Genome Biology, The Hospital for Sick Children, Toronto, ON, Canada
| | - Annie Dupuis
- Clinical Research Services, The Hospital for Sick Children, Toronto, ON, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Janet Shan
- Program in Neurosciences and Mental Health, The Hospital for Sick Children, Toronto, ON, Canada
| | - Tara Goodale
- Program in Neurosciences and Mental Health, The Hospital for Sick Children, Toronto, ON, Canada
| | - S-M Shaheen
- Mathison Centre for Mental Health Research & Education, Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada
| | - Jennifer Crosbie
- Program in Neurosciences and Mental Health, The Hospital for Sick Children, Toronto, ON, Canada.,Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Russell J Schachar
- Institute of Medical Science, University of Toronto, Toronto, ON, Canada.,Program in Neurosciences and Mental Health, The Hospital for Sick Children, Toronto, ON, Canada.,Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Paul D Arnold
- Program in Genetics & Genome Biology, The Hospital for Sick Children, Toronto, ON, Canada.,Mathison Centre for Mental Health Research & Education, Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada.,Departments of Psychiatry and Medical Genetics, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
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15
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Kuwano M, Nakao T, Yonemoto K, Yamada S, Murayama K, Okada K, Honda S, Ikari K, Tomiyama H, Hasuzawa S, Kanba S. Clinical characteristics of hoarding disorder in Japanese patients. Heliyon 2020; 6:e03527. [PMID: 32181397 PMCID: PMC7063155 DOI: 10.1016/j.heliyon.2020.e03527] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2018] [Revised: 02/19/2019] [Accepted: 02/28/2020] [Indexed: 11/30/2022] Open
Abstract
Previous studies have reported clinical characteristics of hoarding disorder (HD), such as early onset, a chronic course, familiality, high unmarried rate, and high rates of comorbidities. However, clinical research targeting Japanese HD patients has been very limited. As a result, there is a low recognition of HD in Japan, leading to insufficient evaluation and treatment of Japanese HD patients. The aim of the current study was to delineate the clinical characteristics of Japanese HD patients. Thirty HD patients, 20 obsessive-compulsive disorder (OCD) patients, and 21 normal controls (NC) were targeted in this study. The HD group had a tendency toward higher familiality, earlier onset, and longer disease duration compared to the OCD group. In addition, the HD group showed a significantly higher unmarried rate than the NC group. The top two comorbidities in the HD group were major depressive disorder (56.7%) and attention-deficit/hyperactivity disorder (26.7%). The HD group had significantly higher scores on hoarding rating scales and lower scores on the Global Assessment of Functioning Scale than the other two groups. The current study showed a clinical trend in Japanese HD patients similar to previous studies in various countries, suggesting that HD may be a universal disease with consistent clinical symptoms.
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Affiliation(s)
- Masumi Kuwano
- Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.,Nagasaki Support Center for Children, Women and People with Disabilities, Nagasaki, Japan
| | - Tomohiro Nakao
- Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Koji Yonemoto
- Advanced Medical Research Center, Faculty of Medicine, University of the Ryukyus, Okinawa, Japan.,Division of Biostatistics, School of Health Sciences, Faculty of Medicine, University of the Ryukyus, Okinawa, Japan
| | - Satoshi Yamada
- Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.,Fukuoka Prefectural Psychiatric Center Dazaifu Hospital, Fukuoka, Japan
| | - Keitaro Murayama
- Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Kayo Okada
- Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.,Okehazama Hospital Fujita Mental Care Center, Aichi, Japan
| | - Shinichi Honda
- Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.,Department of Neuropsychiatry, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan
| | - Keisuke Ikari
- Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Hirofumi Tomiyama
- Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Suguru Hasuzawa
- Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Shigenobu Kanba
- Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
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16
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Mitchell E, Tavares TP, Palaniyappan L, Finger EC. Hoarding and obsessive-compulsive behaviours in frontotemporal dementia: Clinical and neuroanatomic associations. Cortex 2019; 121:443-453. [PMID: 31715541 DOI: 10.1016/j.cortex.2019.09.012] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2018] [Revised: 04/25/2019] [Accepted: 09/20/2019] [Indexed: 12/13/2022]
Abstract
BACKGROUND Hoarding and obsessive-compulsive behaviours (OCB) are well documented symptoms in frontotemporal dementia (FTD). While contemporary models consider hoarding and obsessive-compulsive disorder distinct, the related behaviours have not been separately examined in patients with FTD, and the neuroanatomical correlates of hoarding in patients with FTD have not been previously examined (American Psychiatric Association, 2013; Grisham and Baldwin, 2015; Mataix-Cols et al., 2010). METHODS Patients with FTD who were evaluated between 2004 and 2018 at our centre were included. Cortical thickness and subcortical volumetric analyses were completed on available T1 high resolution anatomic scans using FreeSurfer. RESULTS Eighty-seven patients met inclusion criteria, and 49 had scans available for quantitative MRI volumetric analysis. New hoarding behaviours were present in 29% of patients and were more common in the semantic variant subtype of FTD, while 49% of individuals had new or increased OCB. Hoarding behaviours were associated with decreased thickness in a factor comprised of left temporal, insular and anterior cingulate cortices. The presence of OCB was predicted by reduced cortical thickness and volumes in a factor comprised of the anterior cingulate and subcortical volumes in the bilateral amygdala and hippocampus. OCB were associated with greater right temporal cortical thickness in comparison to patients with hoarding. DISCUSSION The association of the semantic variant with hoarding, together with the observed associations between left temporal atrophy and hoarding indicate that degeneration of the left temporal lobe has a role in the emergence of hoarding in FTD. As in current models of Hoarding disorder and Obsessive-Compulsive disorder, our results suggest that in patients with FTD, hoarding and OCB are clinically and anatomically partially dissociable phenomenon. The results may also help to further elucidate the cognitive processes and neural networks contributing to Hoarding disorder and Obsessive-Compulsive disorder in persons without dementia.
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Affiliation(s)
- Eric Mitchell
- Department of Clinical Neurological Sciences, Schulich School of Medicine and Dentistry, University of Western Ontario, Canada
| | - Tamara P Tavares
- Department of Clinical Neurological Sciences, Schulich School of Medicine and Dentistry, University of Western Ontario, Canada
| | - Lena Palaniyappan
- Department of Psychiatry, Schulich School of Medicine and Dentistry, University of Western Ontario, Canada; Robarts Research Institute, Canada; Lawson Health Research Institute, Canada
| | - Elizabeth C Finger
- Department of Clinical Neurological Sciences, Schulich School of Medicine and Dentistry, University of Western Ontario, Canada; Robarts Research Institute, Canada; Lawson Health Research Institute, Canada; Parkwood Institute, St. Josephs Health Care, Canada.
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17
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Gong F, Li B, Zhang S, Wang Y, Gao Y, Xu Y, Wang X, Xiong B, Li D, Wen R, Qin Z, Wang W. The Suitability of Different Subtypes and Dimensions of Obsessive-Compulsive Disorder for Treatment with Anterior Capsulotomy: A Long-Term Follow-Up Study. Stereotact Funct Neurosurg 2019; 97:319-336. [DOI: 10.1159/000500137] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2018] [Accepted: 04/03/2019] [Indexed: 11/19/2022]
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18
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Scahill L. Editorial: Hoarding and Obsessive-Compulsive Disorder. J Am Acad Child Adolesc Psychiatry 2019; 58:754-755. [PMID: 31108161 DOI: 10.1016/j.jaac.2019.05.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Accepted: 05/13/2019] [Indexed: 10/26/2022]
Abstract
Hoarding disorder is more than surplus clothes and belongings that could be remedied by a visit from Marie Kondo (https://konmari.com). It is officially recognized as a distinct condition in DSM-5 and placed under obsessive-compulsive conditions.1 Before the designation in DSM-5, hoarding was regarded as a diagnostic element in obsessive-compulsive personality disorder or a symptom nested within obsessive-compulsive disorder (OCD).2 In DSM-5, hoarding disorder is defined by great reluctance or outright refusal to discard belongings-including articles of limited value. Individuals with hoarding disorder commonly describe indecision, distress, or both when faced with discarding superfluous items. They may claim that the item could be useful in the future or that it has sentimental value. A direct consequence of refusing to discard items of limited value is accumulation of clutter that, over time, interferes with daily activities and functional use of living space. For example, a sink piled high with dishes and food containers may not be available for practical use. The accumulation of poorly organized possessions may restrict movement in the home to narrow winding pathways through the mounds of debris. Excessive accrual of debris may also extend to vehicles. A car stuffed with rags, take-out containers, old mail, cardboard, and rolls of paper towels may not accommodate passengers.
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19
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Say Öcal D, Özdel K, Şafak Y, Kekilli Karnaz Y, Kısa C. A comparison of symptom dimensions for obsessive compulsive disorder and obsessive compulsive-related disorders. PLoS One 2019; 14:e0218955. [PMID: 31276509 PMCID: PMC6611656 DOI: 10.1371/journal.pone.0218955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2018] [Accepted: 06/12/2019] [Indexed: 11/19/2022] Open
Abstract
Objective In this study, it is aimed to determine obsessive compulsive-related disorders (OCRDs) comorbidity among the patients with obsessive compulsive disorder (OCD) and compare patients with OCD with or without comorbid OCRDs in terms of the severity of their OCD symptoms, symptom dimensions, and comorbidity with other axis I disorders. Methods The study included 90 patients diagnosed as having OCD according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR). The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) diagnostic criteria for OCRDs were used to determine the presence of OCRDs. In order to determine the symptom dimensions and severity of these individuals’ OCD symptoms, we administered the Dimensional Obsessive Compulsive Scale (DOCS) and The Yale-Brown Obsessive Compulsive Scale (Y-BOCS). Results In our study, 20% of the patients with OCD simultaneously met the criteria for at least one OCRD, we also found that a significantly greater proportion of this group were men. None of the mentioned disorders was associated with any symptom dimensions we evaluated using DOCS. In addition, no differences were found in the severity of OCD symptoms and comorbid axis I disorders between the group with comorbid OCRDs and the group without comorbid OCRDs. Discussion There was no significant relationship between the symptom dimensions of OCD and OCRDs. It is found that OCRD comorbidity does not increase the severity of OCD symptoms and the prevalence of an axis I diagnosis.
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Affiliation(s)
- Derya Say Öcal
- Department of Psychiatry, Kecioren Training and Research Hospital, Ankara, Turkey
- * E-mail:
| | - Kadir Özdel
- Department of Psychiatry, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey
| | - Yasir Şafak
- Department of Psychiatry, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey
| | | | - Cebrail Kısa
- Department of Psychology, İstanbul Aydın University, İstanbul, Turkey
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20
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Kajitani K, Tsuchimoto R, Nagano J, Nakao T. Relevance of hoarding behavior and the traits of developmental disorders among university students: a self-reported assessment study. Biopsychosoc Med 2019; 13:13. [PMID: 31171932 PMCID: PMC6545730 DOI: 10.1186/s13030-019-0156-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2019] [Accepted: 05/22/2019] [Indexed: 11/22/2022] Open
Abstract
Background Previous studies have shown that hoarding behavior usually starts at a subclinical level in early adolescence and gradually worsens; however, a limited number of studies have examined the prevalence of hoarding behavior and its association with developmental disorders in young adults. The aims of this study were to estimate the prevalence of hoarding behavior and to identify correlations between hoarding behavior and developmental disorder traits in university students. Methods The study participants included 801 university students (616 men, 185 women) who completed questionnaires (ASRS: Adult ADHD Self-Report Scale version 1.1, AQ16: Autism-Spectrum Quotient with 16 items, and CIR: Clutter Image Rating). Results Among 801 participants, 27 (3.4%) exceeded the CIR cut-off score. Moreover, the participants with hoarding behavior had a significantly higher percentage of ADHD traits compared to participants without hoarding behavior (HB(+) vs HB(−), 40.7% vs 21.7%). In addition, 7.4% of HB(+) participants had autism spectrum disorder (ASD) traits, compared to 4.1% of HB(−) participants. A correlation analysis revealed that the CIR composite score had a stronger correlation with the ASRS inattentive score than with the hyperactivity/impulsivity score (CIR composite vs ASRS IA, r = 0.283; CIR composite vs ASRS H/I, r = 0.147). Conclusions The results showed a high prevalence of ADHD traits in the university students with hoarding behavior. Moreover, we found that the hoarding behavior was more strongly correlated with inattentive symptoms rather than with hyperactivity/impulsivity symptoms. Our results support the concept of a common pathophysiology behind hoarding behavior and ADHD in young adults.
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Affiliation(s)
- Kosuke Kajitani
- 1Center for Health Sciences and Counseling, Kyushu University, 6-1 Kasuga-koen, Kasuga, Fukuoka, 816-8580 Japan
| | - Rikako Tsuchimoto
- 1Center for Health Sciences and Counseling, Kyushu University, 6-1 Kasuga-koen, Kasuga, Fukuoka, 816-8580 Japan
| | - Jun Nagano
- 1Center for Health Sciences and Counseling, Kyushu University, 6-1 Kasuga-koen, Kasuga, Fukuoka, 816-8580 Japan
| | - Tomohiro Nakao
- 2Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi Higashi-ku, Fukuoka, Japan
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Zaboski BA, Merritt OA, Schrack AP, Gayle C, Gonzalez M, Guerrero LA, Dueñas JA, Soreni N, Mathews CA. Hoarding: A meta-analysis of age of onset. Depress Anxiety 2019; 36:552-564. [PMID: 30958911 DOI: 10.1002/da.22896] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2018] [Revised: 02/28/2019] [Accepted: 03/22/2019] [Indexed: 12/25/2022] Open
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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Affiliation(s)
- Brian A Zaboski
- Department of Psychiatry, Division of Psychology, Gainesville, Florida.,Department of School of Special Education, School Psychology, and Early Childhood Studies, University of Florida, Gainesville, Florida
| | - Olivia A Merritt
- Department of Psychiatry and Behavioral Neurosciences, Pediatric OCD Consultation Service, Anxiety Treatment and Research Clinic, McMaster University, Hamilton, Ontario
| | - Anna P Schrack
- Department of Psychiatry, Division of Psychology, Gainesville, Florida.,Department of School of Special Education, School Psychology, and Early Childhood Studies, University of Florida, Gainesville, Florida
| | - Cindi Gayle
- Department of Psychiatry, Division of Psychology, Gainesville, Florida
| | - Melissa Gonzalez
- Department of Psychiatry, Division of Psychology, Gainesville, Florida.,Department of School of Special Education, School Psychology, and Early Childhood Studies, University of Florida, Gainesville, Florida
| | - Lisa A Guerrero
- Department of Psychiatry, Division of Psychology, Gainesville, Florida.,Department of School of Special Education, School Psychology, and Early Childhood Studies, University of Florida, Gainesville, Florida
| | - Julisa A Dueñas
- Department of School of Special Education, School Psychology, and Early Childhood Studies, University of Florida, Gainesville, Florida
| | - Noam Soreni
- Department of Psychiatry and Behavioral Neurosciences, Pediatric OCD Consultation Service, Anxiety Treatment and Research Clinic, McMaster University, Hamilton, Ontario
| | - Carol A Mathews
- Department of Psychiatry, Center for OCD, Anxiety, and Related Disorders, McKnight Brain Institute, College of Medicine, University of Florida, Gainesville, Florida
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22
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Hombali A, Sagayadevan V, Tan WM, Chong R, Yip HW, Vaingankar J, Chong SA, Subramaniam M. A narrative synthesis of possible causes and risk factors of hoarding behaviours. Asian J Psychiatr 2019; 42:104-114. [PMID: 31003207 DOI: 10.1016/j.ajp.2019.04.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2018] [Revised: 03/07/2019] [Accepted: 04/07/2019] [Indexed: 10/27/2022]
Abstract
BACKGROUND Hoarding is a disorder characterized by excessive acquisition and persistent difficulty in discarding possessions. The behaviour has adverse emotional, physical, social, financial, and legal outcomes for the person with the disorder and family members, and might pose a significant public health problem. Hoarding has been included as a distinct disorder in the Diagnostic and Statistical Manual of Mental Disorders Fifth edition (DSM-5). The prevalence of hoarding disorder is approximately 2-6% globally. The current state of the evidence does not offer clear understanding of the causes of hoarding behaviours. A systematic review of the extant literature was carried out to determine the possible causal factors of hoarding behaviours. METHODS This review is conducted in line with PRISMA guidelines. The following electronic databases: Medline through Ovid, EMBASE and PsycINFO were searched for relevant articles published between January 2000 and November 2018. Only articles published in English language were included. Two reviewers independently scrutinized the studies and included them in this review. RESULTS Our search strategy returned a total of 396 references. Preliminary findings suggest that individuals with hoarding behaviours may have a genetic susceptibility; abnormal neural activity in the fronto-temporal, para-hippocampal gyrus and insular parts of the brain has also been identified. Traumatic life experiences have also been posited to predispose individuals to hoard. CONCLUSION Although the understanding of hoarding disorder hasgrown in recent years, greater efforts are still needed to clarify the etiology and mechanisms of hoarding disorder as these may help in planning of more holistic interventions to treat the problem.
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Affiliation(s)
- Aditi Hombali
- Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, 539747, Singapore
| | - Vathsala Sagayadevan
- Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, 539747, Singapore
| | - Weng Mooi Tan
- Agency for Integrated Care, Community Mental Health Division, Singapore
| | - Rebecca Chong
- Agency for Integrated Care, Community Mental Health Division, Singapore
| | - Hon Weng Yip
- Policy & Planning Division, Municipal Services Office, Singapore
| | - Janhavi Vaingankar
- Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, 539747, Singapore
| | - Siow Ann Chong
- Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, 539747, Singapore
| | - Mythily Subramaniam
- Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, 539747, Singapore.
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Congruence and discrepancy between self-rated and clinician-rated symptom severity on the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) before and after a low-intensity intervention. Psychiatry Res 2019; 273:595-602. [PMID: 30716599 DOI: 10.1016/j.psychres.2019.01.092] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2018] [Revised: 01/28/2019] [Accepted: 01/28/2019] [Indexed: 11/21/2022]
Abstract
The Yale-Brown Obsessive Compulsive Scale (Y-BOCS) is the most common measure of Obsessive-Compulsive symptom severity. The Y-BOCS interview is considered gold standard, but its self-rating format is increasingly used in clinical trials. Few studies investigated congruency and potential changes over treatment. This question is highly relevant, as a systematic bias might obscure results of clinical trials. We examined the relationship of self- and clinician-rated Y-BOCS scores in participants with obsessive-compulsive disorder in pre (N = 128), post, (4 weeks, n = 104) and follow-up (6 months, n = 98) assessments of a randomized-controlled clinical trial. We administered Y-BOCS interview via telephone paralleling online administration of the self-report form. Analyses showed medium-to-strong correlations of Y-BOCS interview and self-rating scores at pre-assessment. Patients rated symptoms lower than clinicians. Larger discrepancies were associated with hoarding and age. Congruency was inferior for obsessions relative to compulsions, largely owing to the "resistance against obsessions" item. Agreement strongly increased at post and follow-up. Though overall congruency between the two Y-BOCS forms was satisfactory, results suggest a "correction over time" effect. Such bias may distort the precise interpretation of treatment effects. Therefore, we made several suggestions to improve the reliability of change scores assessed with the Y-BOCS self-rating.
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24
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Soreni N, Cameron D, Vorstenbosch V, Duku E, Rowa K, Swinson R, Bullard C, McCabe R. Psychometric Evaluation of a Revised Scoring Approach for the Children's Saving Inventory in a Canadian Sample of Youth With Obsessive-Compulsive Disorder. Child Psychiatry Hum Dev 2018; 49:966-973. [PMID: 29797231 DOI: 10.1007/s10578-018-0811-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Abstract
The Children's Saving Inventory (CSI) was introduced in 2011 and is the first parent-rated questionnaire specifically designed to measure the severity of hoarding symptoms in youth. To date, however, no replication studies of the CSI have been published. Additionally, the total CSI score includes several items measuring acquisition, a behavioural dimension that has since been excluded from DSM-5's hoarding disorder criteria. Given these limitations, the primary goal of the present study was to test a modified, DSM-5-consistent, total score of the CSI. Because a confirmatory factor analysis did not support the 2011 four-factor model of the CSI, we reviewed the original CSI and excluded all acquisition items. An exploratory factor analysis yielded a strong three-factor solution (difficulty discarding, Clutter, and distress/impairment) with good reliability and validity for a 15-item version of the CSI. Overall, our results support the use of the 15-item CSI in youth with OCD.
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Affiliation(s)
- Noam Soreni
- Offord Centre for Child Studies, McMaster University, 175 Longwood Rd S #105, Hamilton, ON, L8P 0A1, Canada. .,Anxiety Treatment and Research Centre, St. Joseph's Healthcare, 100 West 5th Street, Hamilton, ON, L8N 3K7, Canada. .,Department of Psychiatry and Behavioural Neurosciences, McMaster University, West 5th Campus, 100 West 5th, Hamilton, ON, L8N 3K7, Canada. .,Pediatric OCD Consultation Team, Anxiety Treatment and Research Centre, St. Joseph's Healthcare, 100 West 5th Street, Hamilton, ON, L8N 3K7, Canada.
| | - Duncan Cameron
- Anxiety Treatment and Research Centre, St. Joseph's Healthcare, 100 West 5th Street, Hamilton, ON, L8N 3K7, Canada
| | - Valerie Vorstenbosch
- Eating Disorders Program, Homewood Health Centre, 150 Delhi Street, Guelph, ON, N1E 6K9, Canada
| | - Eric Duku
- Offord Centre for Child Studies, McMaster University, 175 Longwood Rd S #105, Hamilton, ON, L8P 0A1, Canada.,Department of Psychiatry and Behavioural Neurosciences, McMaster University, West 5th Campus, 100 West 5th, Hamilton, ON, L8N 3K7, Canada
| | - Karen Rowa
- Anxiety Treatment and Research Centre, St. Joseph's Healthcare, 100 West 5th Street, Hamilton, ON, L8N 3K7, Canada.,Department of Psychiatry and Behavioural Neurosciences, McMaster University, West 5th Campus, 100 West 5th, Hamilton, ON, L8N 3K7, Canada
| | - Richard Swinson
- Anxiety Treatment and Research Centre, St. Joseph's Healthcare, 100 West 5th Street, Hamilton, ON, L8N 3K7, Canada.,Department of Psychiatry and Behavioural Neurosciences, McMaster University, West 5th Campus, 100 West 5th, Hamilton, ON, L8N 3K7, Canada
| | - Carrie Bullard
- Anxiety Treatment and Research Centre, St. Joseph's Healthcare, 100 West 5th Street, Hamilton, ON, L8N 3K7, Canada.,School of Nursing, McMaster University, 1280 Main Street West, Hamilton, ON, L8S 4L8, Canada.,Pediatric OCD Consultation Team, Anxiety Treatment and Research Centre, St. Joseph's Healthcare, 100 West 5th Street, Hamilton, ON, L8N 3K7, Canada
| | - Randi McCabe
- Anxiety Treatment and Research Centre, St. Joseph's Healthcare, 100 West 5th Street, Hamilton, ON, L8N 3K7, Canada.,Department of Psychiatry and Behavioural Neurosciences, McMaster University, West 5th Campus, 100 West 5th, Hamilton, ON, L8N 3K7, Canada
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Borda T, Gardini DH, Neziroglu F. Comorbid Hoarding and Obsessive Compulsive Disorder Manifested During Early Childhood. Clin Case Stud 2018. [DOI: 10.1177/1534650118782652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This case report outlines the use of cognitive behavioral therapy (CBT) used to treat an 11-year-old female, “Gabriela,” with comorbid hoarding and obsessive compulsive disorder (OCD). Gabriela participated in treatment involving CBT and exposure and response prevention (ERP) sessions for OCD and hoarding, following a cognitive rehabilitation software program designed for cognitive impairment. Upon completion of the treatment, Gabriela no longer exhibited behaviors consistent with a comorbid hoarding and OCD diagnosis and demonstrated marked improvements in her presenting problems (mental rituals; hoarding items for magical thinking purposes). This case report supports the focus of research, continuing to explore hoarding and comorbidity diagnoses across the life span.
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Affiliation(s)
- Tania Borda
- Bio Behavioral Institute, Buenos Aires, Argentina
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26
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Self-reported executive function and hoarding in adults with obsessive-compulsive disorder. Compr Psychiatry 2018; 81:53-59. [PMID: 29268152 DOI: 10.1016/j.comppsych.2017.11.009] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2017] [Revised: 11/22/2017] [Accepted: 11/26/2017] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Hoarding behavior may distinguish a clinically and possibly etiologically distinct subtype of obsessive-compulsive disorder (OCD). Little is known about the relationship between executive dysfunction and hoarding in individuals with OCD. METHODS The study sample included 431 adults diagnosed with DSM-IV OCD. Participants were assessed by clinicians for Axis I disorders, personality disorders, indecision, and hoarding. Executive functioning domains were evaluated using a self-report instrument, the Behavior Rating Inventory of Executive Function-Adult Version (BRIEF-A). We compared scores on these domains in the 143 hoarding and 288 non-hoarding participants, separately in men and women. We used logistic regression to evaluate relationships between executive function scores and hoarding, and correlation and linear regression analyses to evaluate relationships between executive function scores and hoarding severity, in women. RESULTS In men, the hoarding group had a significantly higher mean score than the non-hoarding group only on the shift dimension. In contrast, in women, the hoarding group had higher mean scores on the shift scale and all metacognition dimensions, i.e., those that assess the ability to systematically solve problems via planning and organization. The relationships in women between hoarding and scores on initiating tasks, planning/organizing, organization of materials, and the metacognition index were independent of other clinical features. Furthermore, the severity of hoarding in women correlated most strongly with metacognition dimensions. CONCLUSIONS Self-reported deficits in planning and organization are associated with the occurrence and severity of hoarding in women, but not men, with OCD. This may have implications for elucidating the etiology of, and developing effective treatments for, hoarding in OCD.
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27
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Gaston RL, Kiran-Imran F, Hassiem F, Vaughan J. Hoarding behaviour: building up the ‘R factor’. ACTA ACUST UNITED AC 2018. [DOI: 10.1192/apt.bp.107.005215] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
SummaryHoarding seems to be a non-specific symptom, as it has been associated with a wide range of psychiatric disorders. Validating hoarding as pathological is controversial and its nosological status remains unresolved. ‘Diogenes syndrome’ has been paradigmatic in this area, but its clinical use seems limited. Hoarding is not explicitly covered in either DSM–IV or ICD–10 and literature suggests that diagnosis of mental illness may consequently be missed in this population. In the context of these theoretical uncertainties, clinicians still need to accurately assess and treat patients who show hoarding behaviour. To this end, we summarise the available evidence, and present assessment and management algorithms together with a multicomponent psychological intervention that aims to teach patients to successfully apply the three Rs (reduce, recycle, reuse).
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28
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Hasanpour H, Ghavamizadeh Meibodi R, Navi K, Asadi S. Novel ensemble method for the prediction of response to fluvoxamine treatment of obsessive-compulsive disorder. Neuropsychiatr Dis Treat 2018; 14:2027-2038. [PMID: 30127613 PMCID: PMC6091249 DOI: 10.2147/ndt.s173388] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
OBJECTIVE About 30% of obsessive-compulsive disorder (OCD) patients exhibit an inadequate response to pharmacotherapy. The detection of clinical variables associated with treatment response may result in achievement of remission in shorter period, preventing illness development and reducing socioeconomic costs. METHODS In total, 330 subjects with OCD diagnosis underwent 12-week pharmacotherapy with fluvoxamine (150-300 mg). Treatment response was ≥25% reduction in Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) score. In total, 36 clinical attributes of 151 subjects who had completed their treatment course were analyzed. Data mining algorithms included missing value handling, feature selection, and new analytical method based on ensemble classification. The results were compared with those of other traditional classification algorithms such as decision tree, support vector machines, k-nearest neighbor, and random forest. RESULTS Sexual and contamination obsessions are high-ranked predictors of resistance to fluvoxamine pharmacotherapy as well as high Y-BOCS obsessive score. Our results showed that the proposed analysis strategy has good ability to distinguish responder and nonresponder patients according to their clinical features with 86% accuracy, 79% sensitivity, and 89% specificity. CONCLUSION This study proposed an analytical approach which is an accurate and a sensitive method for the analysis of high-dimensional medical data sets containing more number of missing values. The treatment of OCD could be improved by better understanding of the predictors of pharmacotherapy, which may lead to more effective treatment of patients with OCD.
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Affiliation(s)
- Hesam Hasanpour
- Department of Computer Science and Engineering, Shahid Beheshti University, Tehran, Iran
| | | | - Keivan Navi
- Department of Computer Science and Engineering, Shahid Beheshti University, Tehran, Iran
| | - Sareh Asadi
- Neuroscience Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran,
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29
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Pushkarskaya H, Tolin DF, Henick D, Levy I, Pittenger C. Unbending mind: Individuals with hoarding disorder do not modify decision strategy in response to feedback under risk. Psychiatry Res 2018; 259:506-513. [PMID: 29154203 PMCID: PMC5742085 DOI: 10.1016/j.psychres.2017.11.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2017] [Revised: 10/11/2017] [Accepted: 11/01/2017] [Indexed: 02/06/2023]
Abstract
Cognitive-behavioral models of hoarding disorder emphasize impairments in information processing and decision making in the genesis of hoarding symptomology. We propose and test the novel hypothesis that individuals with hoarding are maladaptively biased towards a deliberative decision style. While deliberative strategies are often considered normative, they are not always adaptable to the limitations imposed by many real-world decision contexts. We examined decision-making patterns in 19 individuals with hoarding and 19 healthy controls, using a behavioral task that quantifies selection of decision strategies in a novel environment with known probabilities (risk) in response to feedback. Consistent with prior literature, we found that healthy individuals tend to explore different decision strategies in the beginning of the experiment, but later, in response to feedback, they shift towards a compound strategy that balances expected values and risks. In contrast, individuals with hoarding follow a simple, deliberative, risk-neutral, value-based strategy from the beginning to the end of the task, irrespective of the feedback. This seemingly rational approach was not ecologically rational: individuals with hoarding and healthy individuals earned about the same amount of money, but it took individuals with hoarding a lot longer to do it: additional cognitive costs did not lead to additional benefits.
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Affiliation(s)
- Helen Pushkarskaya
- Section of Comparative Medicine, Yale School of Medicine, New Haven, CT 06510, United States.
| | - David F Tolin
- Department of Psychology, Yale University, New Haven, CT 06510, United States; Anxiety Disorders Center, Institute of Living, Hartford Hospital, Hartford, CT 06114, United States
| | - Daniel Henick
- Department of Psychology, Yale University, New Haven, CT 06510, United States
| | - Ifat Levy
- Section of Comparative Medicine, Yale School of Medicine, New Haven, CT 06510, United States; Department of Neurobiology, Yale School of Medicine, New Haven, CT 06510, United States
| | - Christopher Pittenger
- Department of Psychiatry, Yale School of Medicine, New Haven, CT 06510, United States; Department of Psychology, Yale University, New Haven, CT 06510, United States; Child Study Center, Yale School of Medicine, New Haven, CT 06510, United States
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30
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Aso Y, Yamaoka K, Nemoto A, Naganuma Y, Saito M. Effectiveness of a 'Workshop on Decluttering and Organising' programme for teens and middle-aged adults with difficulty decluttering: a study protocol of an open-label, randomised, parallel-group, superiority trial in Japan. BMJ Open 2017; 7:e014687. [PMID: 28601822 PMCID: PMC5541631 DOI: 10.1136/bmjopen-2016-014687] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION Hoarding disorder can cause problems with work performance, personal hygiene, health and well-being. The disorder is a growing social problem in Japan. Having difficulty discarding rubbish, decluttering and organising can signal a future hoarding disorder, and early intervention is important. We developed an educational workshop on decluttering and organising for teens and adults with difficulty organising. The objective of this study is to evaluate the effectiveness of a workshop for reducing clutter and improving quality of life among younger people with difficulty decluttering and organising. METHODS AND ANALYSIS An open-label, parallel-group, randomised controlled trial will be conducted among volunteers aged 12-55 years with mild difficulty decluttering and organising. Those in the intervention group will attend the workshop and receive a visit from a professional cleaning company to declutter their living space. The control group will have only the latter. The primary outcome will be the score on the Japanese version of the Saving Inventory-Revised. Secondary outcomes will be scores on the Clutter Image Rating Scale, the Japanese version of the Rosenberg Self-Esteem Scale and the Roles of Private Space Scale. The results will be examined for differences between the two groups in changes from baseline to 7 months. We will examine crude effects and adjust for gender and age using a general linear model for continuous variables and a logistic regression model for dichotomous variables. Sample size was calculated assuming a significance level of 5% (two tailed), a power of 80% and an effect size of 0.75. In total, 60 subjects (30 in each group) will be required. ETHICS AND DISSEMINATION The study protocol has been approved by the Medical Ethical Committee of Teikyo University (No. 15-065). The findings will be disseminated widely through peer-reviewed publication and conference presentations. TRIAL REGISTRATION NUMBER UMIN000020568. Issue date: 16 January 2016.
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Affiliation(s)
- Yasuko Aso
- Department of Nursing, Faculty of Health Sciences, Tsukuba International University, Tuchiura, Ibaraki, Japan
- Teikyo University Graduate School of Public Health, Tokyo, Japan
| | - Kazue Yamaoka
- Teikyo University Graduate School of Public Health, Tokyo, Japan
| | - Asuka Nemoto
- Teikyo University Graduate School of Public Health, Tokyo, Japan
| | - Yuki Naganuma
- Department of Nursing, Faculty of Nursing, Tokyo Ariake University of Medical and Health Sciences, Tokyo, Japan
| | - Masashige Saito
- Department of Social Welfare, Faculty of Social Welfare, Nihon Fukushi University, Aichi, Japan
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31
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Bello MS, Pang RD, Chasson GS, Ray LA, Leventhal AM. Obsessive-compulsive symptoms and negative affect during tobacco withdrawal in a non-clinical sample of African American smokers. J Anxiety Disord 2017; 48:78-86. [PMID: 27769664 PMCID: PMC5380588 DOI: 10.1016/j.janxdis.2016.10.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2016] [Revised: 10/01/2016] [Accepted: 10/03/2016] [Indexed: 10/20/2022]
Abstract
The association between obsessive-compulsive (OC) symptomatology and smoking is poorly understood, particularly in African Americans-a group subject to smoking- and OC-related health disparities. In a non-clinical sample of 253 African American smokers, we tested the negative reinforcement model of OC-smoking comorbidity, purporting that smokers with higher OC symptoms experience greater negative affect (NA) and urge to smoke for NA suppression upon acute tobacco abstinence. Following a baseline visit involving OC assessment, participants completed two counterbalanced experimental visits (non-abstinent vs. 16-h tobacco abstinence) involving affect, smoking urge, and nicotine withdrawal assessment. OC symptom severity predicted larger abstinence-provoked increases in overall NA, anger, anxiety, depression, fatigue, urge to smoke to suppress NA, and composite nicotine withdrawal symptom index. African American smokers with elevated OC symptoms appear to be vulnerable to negative reinforcement-mediated smoking motivation and may benefit from cessation treatments that diminish NA or the urge to quell NA via smoking.
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Affiliation(s)
- Mariel S Bello
- University of Southern California, Department of Psychology, Los Angeles, CA, USA
| | - Raina D Pang
- University of Southern California Keck School of Medicine, Department of Preventive Medicine, Los Angeles, CA, USA
| | - Gregory S Chasson
- Illinois Institute of Technology, Department of Psychology, Chicago, IL, USA
| | - Lara A Ray
- University of California Los Angeles, Department of Psychology, Los Angeles, CA, USA
| | - Adam M Leventhal
- University of Southern California, Department of Psychology, Los Angeles, CA, USA; University of Southern California Keck School of Medicine, Department of Preventive Medicine, Los Angeles, CA, USA.
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Cath DC, Nizar K, Boomsma D, Mathews CA. Age-Specific Prevalence of Hoarding and Obsessive Compulsive Disorder: A Population-Based Study. Am J Geriatr Psychiatry 2017; 25:245-255. [PMID: 27939851 PMCID: PMC5316500 DOI: 10.1016/j.jagp.2016.11.006] [Citation(s) in RCA: 70] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2016] [Revised: 11/07/2016] [Accepted: 11/09/2016] [Indexed: 01/23/2023]
Abstract
OBJECTIVE Little is known about the age-specific prevalence of hoarding and obsessive compulsive symptoms (OCS), particularly in older age groups. The objectives of this study were to estimate the age-specific prevalence, severity, and relationships between hoarding and OCS in males and females using a large population-based sample. METHODS We assessed the age-specific prevalence rates of hoarding disorder (HD) and OC disorder (OCD) in males and females (at various age ranges between 15 and 97 years) from the Netherlands Twins Register (N = 15,194). Provisional HD and OCD diagnoses were made according to Diagnostic and Statistical Manual of Mental Health Disorders, 5th Edition, criteria using self-report measures. We also assessed hoarding and OCS severity in the various age groups and explored specific hoarding and OCS 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. Co-occurring OCD increased hoarding symptom severity (coefficient: 4.5; SE: 0.2; 95% CI: 4.1-4.9; t = 22.0, p < 0.0001). Difficulty discarding for HD and checking behaviors for OCD appeared to drive most increases in these diagnoses in older ages. CONCLUSION 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.
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Affiliation(s)
- Danielle C Cath
- Department of Clinical Psychology, Utrecht University, the Netherlands, University Medical Center Groningen, Department of Psychiatry, Rob Giel Onderzoekscentrum, Groningen, the Netherlands
| | - Krystal Nizar
- Department of Psychiatry, University of California, San Francisco, San Francisco, CA
| | - Dorret Boomsma
- Department of Biological Psychology, Vrije Universiteit, Amsterdam, the Netherlands
| | - Carol A Mathews
- Department of Psychiatry, University of Florida, Gainesville, FL.
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Parental bonding and hoarding in obsessive-compulsive disorder. Compr Psychiatry 2017; 73:43-52. [PMID: 27915218 PMCID: PMC5479319 DOI: 10.1016/j.comppsych.2016.11.004] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2016] [Revised: 11/07/2016] [Accepted: 11/11/2016] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Hoarding behavior may indicate a clinically and possibly etiologically distinct subtype of obsessive-compulsive disorder (OCD). Empirical evidence supports a relationship between hoarding and emotional over-attachment to objects. However, little is known about the relationship between hoarding and parental attachment in OCD. METHOD The study sample included 894 adults diagnosed with DSM-IV OCD who had participated in family and genetic studies of OCD. Participants were assessed for Axis I disorders, personality disorders, and general personality dimensions. The Parental Bonding Instrument (PBI) was used to assess dimensions of perceived parental rearing (care, overprotection, and control). We compared parental PBI scores in the 334 hoarding and 560 non-hoarding participants, separately in men and women. We used logistic regression to evaluate the relationship between parenting scores and hoarding in women, adjusting for other clinical features associated with hoarding. RESULTS In men, there were no significant differences between hoarding and non-hoarding groups in maternal or paternal parenting scores. In women, the hoarding group had a lower mean score on maternal care (23.4 vs. 25.7, p<0.01); a higher mean score on maternal protection (9.4 vs. 7.7, p<0.001); and a higher mean score on maternal control (7.0 vs. 6.2, p<0.05), compared to the non-hoarding group. The magnitude of the relationships between maternal bonding dimensions and hoarding in women did not change after adjustment for other clinical features. Women who reported low maternal care/high maternal protection had significantly greater odds of hoarding compared to women with high maternal care/low maternal protection (OR=2.54, 95% CI=1.60-4.02, p<0.001). CONCLUSIONS Perceived poor maternal care, maternal overprotection, and maternal overcontrol are associated with hoarding in women with OCD. Parenting dimensions are not related to hoarding in men. These findings provide further support for a hoarding subtype of OCD and for sex-specific differences in etiologic pathways for hoarding in OCD.
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34
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Tsuchiyagaito A, Horiuchi S, Igarashi T, Kawanori Y, Hirano Y, Yabe H, Nakagawa A. Factor structure, reliability, and validity of the Japanese version of the Hoarding Rating Scale-Self-Report (HRS-SR-J). Neuropsychiatr Dis Treat 2017; 13:1235-1243. [PMID: 28533685 PMCID: PMC5431741 DOI: 10.2147/ndt.s133471] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND The Hoarding Rating Scale-Self-Report (HRS-SR) is a five-item scale that assesses the symptoms of hoarding. These symptoms include excessive acquisition, difficulty in discarding, and excessive clutter that causes distress. We conducted three studies to examine the factor structure, reliability, and validity of the Japanese version of the HRS-SR (HRS-SR-J). METHODS Study 1 examined its reliability; 193 college students and 320 adolescents and adults completed the HRS-SR-J and, of the college students, 32 took it again 2 weeks later. Study 2 aimed to confirm that its scores in a sample of 210 adolescents and adults are independent of social desirability. Study 3 aimed to validate the HRS-SR-J in the aspects of convergent and discriminant validity in a sample of 550 adults. RESULTS The HRS-SR-J showed good internal consistency and 2-week test-retest reliability. Based on the nonsignificant correlations between the HRS-SR-J and social desirability, the HRS-SR-J was not strongly affected by social desirability. In addition, it also had a good convergent validity with the Japanese version of the Saving Inventory-Revised (SI-R-J) and the hoarding subscale of the Obsessive-Compulsive Inventory, while having a significantly weaker correlation with the five subscales of the Obsessive-Compulsive Inventory, except for the hoarding subscale. In addition, the strength of the correlation between the HRS-SR-J and the Japanese version of the Patient Health Questionnaire-9 and that between the HRS-SR-J and the Generalized Anxiety Disorder-7 were significantly weaker than the correlation between the HRS-SR-J and the SI-R-J. These results demonstrate that the HRS-SR-J has good convergent and discriminant validity. CONCLUSION The HRS-SR-J is a notable self-report scale for examining the severity of hoarding symptoms.
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Affiliation(s)
- Aki Tsuchiyagaito
- Research Center for Child Mental Development, Chiba University, Chiba.,Department of Neuropsychiatry, Fukushima Medical University, Fukushima.,United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University and University of Fukui, Osaka
| | | | - Toko Igarashi
- Graduate School of Education, Joetsu University of Education, Niigata, Japan
| | | | - Yoshiyuki Hirano
- Research Center for Child Mental Development, Chiba University, Chiba.,United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University and University of Fukui, Osaka
| | - Hirooki Yabe
- Department of Neuropsychiatry, Fukushima Medical University, Fukushima
| | - Akiko Nakagawa
- Research Center for Child Mental Development, Chiba University, Chiba.,United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University and University of Fukui, Osaka
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35
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Raines AM, Short NA, Fuller KL, Allan NP, Oglesby ME, Schmidt NB. Hoarding and depression: The mediating role of perceived burdensomeness. J Psychiatr Res 2016; 83:24-28. [PMID: 27543825 DOI: 10.1016/j.jpsychires.2016.08.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2016] [Revised: 07/16/2016] [Accepted: 08/04/2016] [Indexed: 11/16/2022]
Abstract
Despite clear indications that hoarding behaviors contribute to social isolation and strained family relationships, no research to date has examined the associations between hoarding and several important interpersonal constructs (i.e., perceived burdensomeness and thwarted belongingness). Moreover, no research has examined how these various interpersonal needs may account for the associations between symptoms of hoarding and depression. Community participants (N = 125) with elevated hoarding symptoms were assessed on the interpersonal constructs of interest. Hoarding severity was significantly associated with perceived burdensomeness even after controlling for overall levels of negative affect. Moreover, perceived burdensomeness significantly mediated the relationship between hoarding severity and depressive symptoms. To our knowledge this is the first study to examine potential mechanisms that may account for the robust associations between hoarding and depression. Future investigations should attempt to replicate these findings using clinical samples.
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Affiliation(s)
- Amanda M Raines
- Department of Psychology, Florida State University, 1107 W. Call St., Tallahassee, FL 32306-4301, USA
| | - Nicole A Short
- Department of Psychology, Florida State University, 1107 W. Call St., Tallahassee, FL 32306-4301, USA
| | - Kelly L Fuller
- Department of Psychology, Florida State University, 1107 W. Call St., Tallahassee, FL 32306-4301, USA
| | - Nicholas P Allan
- Department of Psychology, Florida State University, 1107 W. Call St., Tallahassee, FL 32306-4301, USA
| | - Mary E Oglesby
- Department of Psychology, Florida State University, 1107 W. Call St., Tallahassee, FL 32306-4301, USA
| | - Norman B Schmidt
- Department of Psychology, Florida State University, 1107 W. Call St., Tallahassee, FL 32306-4301, USA.
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Novara C, Bottesi G, Dorz S, Sanavio E. Hoarding Symptoms Are Not Exclusive to Hoarders. Front Psychol 2016; 7:1742. [PMID: 27891104 PMCID: PMC5102881 DOI: 10.3389/fpsyg.2016.01742] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2016] [Accepted: 10/24/2016] [Indexed: 11/20/2022] Open
Abstract
Hoarding disorder (HD) was originally conceptualized as a subcategory of obsessive compulsive disorder (OCD), and numerous studies have in fact focused exclusively on investigating the comorbidity between OCD and HD. Hoarding behavior can nevertheless also be found in other clinical populations and in particular in patients with eating disorders (ED), anxiety disorders (AD), major depression (MD), and psychotic disorders (PD). The current study was carried out with the aim of investigating, using a validated instrument such as the Saving Inventory-Revised (SI-R), the presence of HD symptoms in patients diagnosed with ED, AD, MD, and PD. Hoarding symptomatology was also assessed in groups of self-identified hoarders and healthy controls. The results revealed that 22.5% of the ED patients exceeded the cut-off for the diagnosis of HD, followed by 7.7% of the patients with MD, 7.4% of the patients with AD, and 5.9% of the patients with PD. The patients with ED had significantly higher SI-R scores than the other groups in the Acquisition and Difficulty Discarding scales while the AD, MD, and PD patients were characterized exclusively by Difficulty Discarding. These data suggest to clinicians that hoarding symptoms should be assessed in other types of patients and especially in those affected by Bulimia and Binge eating.
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Affiliation(s)
- Caterina Novara
- Department of General Psychology, University of Padova Padova, Italy
| | - Gioia Bottesi
- Department of General Psychology, University of Padova Padova, Italy
| | | | - Ezio Sanavio
- Department of General Psychology, University of Padova Padova, Italy
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Validation of the clutter image rating (CIR) scale among psychiatric outpatients in Singapore. BMC Psychiatry 2016; 16:407. [PMID: 27855683 PMCID: PMC5114741 DOI: 10.1186/s12888-016-1125-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2016] [Accepted: 11/11/2016] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND The Clutter Image Rating (CIR) Scale though extensively used to assess hoarding behavior, has mainly been validated in Western populations. METHODS The current study sought to validate the CIR in a sample of psychiatric outpatients (n = 500) in Singapore. Convergent and divergent validity as well as inter-observer reliabilities between participant CIR and interviewer-rated CIR were calculated. RESULTS The CIR performed fairly in identifying participants with and without hoarding problems according to the Savings Inventory Revised (SI-R). The CIR composite demonstrated good convergent validity with the SI-R clutter subscale, the SI-R total and the Activities of Daily Living Scale for Hoarding (ADL-H) scale and discriminant validity with the Beck Anxiety Inventory (BAI), Beck Depression Inventory (BDI), and Quality of Life Enjoyment and Satisfaction Questionnaire - Short Form (Q-LES-Q-SF) scale. CONCLUSIONS Findings add valuable knowledge to the utility of the CIR in an Asian population.
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Park JM, Samuels JF, Grados MA, Riddle MA, Bienvenu OJ, Goes FS, Cullen B, Wang Y, Krasnow J, Murphy DL, Rasmussen SA, McLaughlin NC, Piacentini J, Pauls DL, Stewart SE, Shugart YY, Maher B, Pulver AE, Knowles JA, Greenberg BD, Fyer AJ, McCracken JT, Nestadt G, Geller DA. ADHD and executive functioning deficits in OCD youths who hoard. J Psychiatr Res 2016; 82:141-8. [PMID: 27501140 DOI: 10.1016/j.jpsychires.2016.07.024] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2016] [Revised: 06/29/2016] [Accepted: 07/28/2016] [Indexed: 10/21/2022]
Abstract
Hoarding is common among youth with obsessive compulsive disorder (OCD), with up to 26% of OCD youth exhibiting hoarding symptoms. Recent evidence from adult hoarding and OCD cohorts suggests that hoarding symptoms are associated with executive functioning deficits similar to those observed in subjects with attention deficit hyperactivity disorder (ADHD). However, while hoarding behavior often onsets during childhood, there is little information about executive function deficits and ADHD in affected children and adolescents. The study sample included 431 youths (ages 6-17 years) diagnosed with OCD who participated in the OCD Collaborative Genetics Study and the OCD Collaborative Genetics Association Study and completed a series of clinician-administered and parent report assessments, including diagnostic interviews and measures of executive functioning (Behavior Rating Inventory of Executive Functioning; BRIEF) and hoarding severity (Hoarding Rating Scale-Interview; HRS-I). 113 youths (26%) had clinically significant levels of hoarding compulsions. Youths with and without hoarding differed significantly on most executive functioning subdomains and composite indices as measured by the parent-rated BRIEF. Groups did not differ in the frequency of full DSM-IV ADHD diagnoses; however, the hoarding group had significantly greater number of inattention and hyperactivity symptoms compared to the non-hoarding group. In multivariate models, we found that overall BRIEF scores were related to hoarding severity, adjusting for age, gender and ADHD symptoms. These findings suggest an association between hoarding and executive functioning deficits in youths with OCD, and assessing executive functioning may be important for investigating the etiology and treatment of children and adolescents with hoarding and OCD.
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Affiliation(s)
- Jennifer M Park
- Stanford University School of Medicine, Department of Child and Adolescent Psychiatry, 1195 W Fremont Ave, Sunnyvale, CA, 94087, USA.
| | - Jack F Samuels
- Johns Hopkins University School of Medicine, Department of Psychiatry and Behavioral Sciences, 1800 Orleans St, Baltimore, MD, 21287, USA
| | - Marco A Grados
- Johns Hopkins University School of Medicine, Department of Psychiatry and Behavioral Sciences, 1800 Orleans St, Baltimore, MD, 21287, USA
| | - Mark A Riddle
- Johns Hopkins University School of Medicine, Department of Psychiatry and Behavioral Sciences, 1800 Orleans St, Baltimore, MD, 21287, USA
| | - O Joseph Bienvenu
- Johns Hopkins University School of Medicine, Department of Psychiatry and Behavioral Sciences, 1800 Orleans St, Baltimore, MD, 21287, USA
| | - Fernando S Goes
- Johns Hopkins University School of Medicine, Department of Psychiatry and Behavioral Sciences, 1800 Orleans St, Baltimore, MD, 21287, USA
| | - Bernadette Cullen
- Johns Hopkins University School of Medicine, Department of Psychiatry and Behavioral Sciences, 1800 Orleans St, Baltimore, MD, 21287, USA
| | - Ying Wang
- Johns Hopkins University School of Medicine, Department of Psychiatry and Behavioral Sciences, 1800 Orleans St, Baltimore, MD, 21287, USA
| | - Janice Krasnow
- Johns Hopkins University School of Medicine, Department of Psychiatry and Behavioral Sciences, 1800 Orleans St, Baltimore, MD, 21287, USA
| | - Dennis L Murphy
- Laboratory of Clinical Science, National Institute of Mental Health, National Institute of Health, 6001 Executive Boulevard, Rm 6200, MSC 9663, Bethesda, MD, 20892-9663, USA
| | - Steven A Rasmussen
- Brown Medical School, Department of Psychiatry and Human Behavior, Box G-A1, Providence, RI, 02912, USA
| | - Nicole C McLaughlin
- Brown Medical School, Department of Psychiatry and Human Behavior, Box G-A1, Providence, RI, 02912, USA
| | - John Piacentini
- University of California, Los Angeles School of Medicine, Department of Psychiatry and Biobehavioral Sciences, 757 Westwood Plaza, Los Angeles, CA, 90095, USA
| | - David L Pauls
- Massachusetts General Hospital and Harvard Medical School, Department of Psychiatry, 55 Fruit Street, Boston, MA, 02114, USA
| | - S Evelyn Stewart
- Faculty of Medicine, University of British Columbia, Department of Psychiatry, Detwiller Pavilion, 2255 Wesbrook Mall, Vancouver, BC, V6T 2A1, Canada
| | - Yin-Yao Shugart
- Unit of Statistical Genomics, Division of Intramural Research, National Institute of Mental Health, 6001 Executive Boulevard, Rm 6200, MSC 9663, Bethesda, MD, 20892-9663, USA
| | - Brion Maher
- Johns Hopkins University, Bloomberg School of Public Health, Department of Mental Health, 615 N Wolfe Street, Baltimore, MD, 21205, USA
| | - Ann E Pulver
- Johns Hopkins University School of Medicine, Department of Psychiatry and Behavioral Sciences, 1800 Orleans St, Baltimore, MD, 21287, USA
| | - James A Knowles
- Keck School of Medicine, University of Southern California, 1975 Zonal Avenue, Los Angeles, CA, 90033, USA
| | - Benjamin D Greenberg
- Brown Medical School, Department of Psychiatry and Human Behavior, Box G-A1, Providence, RI, 02912, USA
| | - Abby J Fyer
- College of Physicians and Surgeons at Columbia University and the New York State Psychiatric Institute, Department of Psychiatry, 630 W 168th, Street, New York, NY, 10032, USA
| | - James T McCracken
- University of California, Los Angeles School of Medicine, Department of Psychiatry and Biobehavioral Sciences, 757 Westwood Plaza, Los Angeles, CA, 90095, USA
| | - Gerald Nestadt
- Johns Hopkins University School of Medicine, Department of Psychiatry and Behavioral Sciences, 1800 Orleans St, Baltimore, MD, 21287, USA
| | - Daniel A Geller
- Massachusetts General Hospital and Harvard Medical School, Department of Psychiatry, 55 Fruit Street, Boston, MA, 02114, USA
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Nestadt G, Kamath V, Maher BS, Krasnow J, Nestadt P, Wang Y, Bakker A, Samuels J. Doubt and the decision-making process in obsessive-compulsive disorder. Med Hypotheses 2016; 96:1-4. [PMID: 27959266 PMCID: PMC6013040 DOI: 10.1016/j.mehy.2016.09.010] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2016] [Accepted: 09/19/2016] [Indexed: 10/21/2022]
Abstract
The diagnosis of obsessive-compulsive disorder (OCD) is based on the presence of specific symptoms and their consequence in the lives of those that exhibit them. It is likely that these symptoms emerge from a neurocognitive vulnerability in the mental life of the individual which has a basis in neurophysiology. The prominence of doubt/uncertainty/lack of confidence (These terms are used interchangeably in this paper.), in the clinical presentation of many patients suffering from OCD leads to our consideration of the cognitive basis for this phenomenon. In this paper, we propose that OCD emerges from a perturbation in the decision-making process. Specifically, we hypothesize that there is diminished confidence, conviction, or certainty with regard to assimilating the information necessary to reach a decision. Recent advances in the neuroscience of decision-making provide an opportunity to further our understanding of the vulnerability underlying OCD.
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Affiliation(s)
- Gerald Nestadt
- Johns Hopkins University School of Medicine, Department of Psychiatry and Behavioral Sciences, Baltimore, MD 21205, USA.
| | - Vidyulata Kamath
- Johns Hopkins University School of Medicine, Department of Psychiatry and Behavioral Sciences, Baltimore, MD 21205, USA
| | - Brion S Maher
- Johns Hopkins University Bloomberg School of Public Health, Department of Mental Health, Baltimore, MD 21205, USA
| | - Janice Krasnow
- Johns Hopkins University School of Medicine, Department of Psychiatry and Behavioral Sciences, Baltimore, MD 21205, USA
| | - Paul Nestadt
- Johns Hopkins University School of Medicine, Department of Psychiatry and Behavioral Sciences, Baltimore, MD 21205, USA; Johns Hopkins University Bloomberg School of Public Health, Department of Mental Health, Baltimore, MD 21205, USA
| | - Ying Wang
- Johns Hopkins University School of Medicine, Department of Psychiatry and Behavioral Sciences, Baltimore, MD 21205, USA
| | - Arnold Bakker
- Johns Hopkins University School of Medicine, Department of Psychiatry and Behavioral Sciences, Baltimore, MD 21205, USA
| | - Jack Samuels
- Johns Hopkins University School of Medicine, Department of Psychiatry and Behavioral Sciences, Baltimore, MD 21205, USA
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Tortella-Feliu M, Fullana MA, Caseras X, Andión O, Torrubia R, Mataix-Cols D. Spanish Version of the Savings Inventory–Revised. Behav Modif 2016; 30:693-712. [PMID: 16894237 DOI: 10.1177/0145445505278326] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The factor structure, psychometric properties, and relationship with personality variables of a Spanish version of the Savings Inventory-Revised (SI-R) are investigated in a sample of 381 undergraduate students. A maximum likelihood factor analysis suggests a three-factor structure, which is similar but not identical to that of the original English version. The three factors mirror the three hypothesized domains of compulsive hoarding: acquisition, difficulty discarding, and clutter. The Spanish SI-R demonstrates acceptable high internal consistency and test-retest reliability, but its divergent validity is weaker than expected because of a significant overlap with depressive symptoms. Different SI-R factors are associated with different personality traits: Whereas the difficulty discarding dimension is predominantly associated with susceptibility to punishment, the acquisition dimension is predominantly associated with susceptibility to reward. The authors conclude that the Spanish SI-R is a promising instrument to measure hoarding symptoms.
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Hacker LE, Park JM, Timpano KR, Cavitt MA, Alvaro JL, Lewin AB, Murphy TK, Storch EA. Hoarding in Children With ADHD. J Atten Disord 2016; 20:617-26. [PMID: 22923782 DOI: 10.1177/1087054712455845] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Although evidence suggests that hoarding may be associated with symptoms of ADHD, no study has examined this relationship in children. METHOD Participants included 99 youth diagnosed with ADHD (and a parent) seen in a general outpatient psychiatry clinic. Children completed the Obsessive-Compulsive Inventory-Child Version, the Revised Child Anxiety and Depression Scale, and the Rosenberg Self-Esteem Scale. Parents completed the Children's Saving Inventory and Vanderbilt ADHD Diagnostic Rating Scale-Parent Version. RESULTS Inattentive and hyperactive/impulsive symptoms were the only indicator that differentiated those with and without clinically significant hoarding. Symptoms of ADHD, but not nonhoarding obsessive-compulsive symptoms, significantly predicted hoarding. Inattention and hyperactivity/impulsivity were uniquely associated with individual hoarding features. Hoarding symptoms mediated the relationship between ADHD and oppositionality. CONCLUSION These findings contribute to the growing literature about the association between hoarding and ADHD.
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Affiliation(s)
| | | | | | - Mark A Cavitt
- University of South Florida, Tampa, FL, USA All Children's Hospital, St. Petersburg, FL, USA
| | - Jeffrey L Alvaro
- University of South Florida, Tampa, FL, USA All Children's Hospital, St. Petersburg, FL, USA
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Abstract
This article focuses on the possibility that autism spectrum disorder (ASD: Asperger syndrome, autism and atypical autism) in its milder forms may be clinically important among a substantial proportion of patients with obsessive-compulsive disorder (OCD), and discusses OCD subtypes based on this proposition. The hypothesis derives from extensive clinical experience of OCD and ASD, and literature searches on MEDLINE. Neuropsychological deficits are more common in OCD than in panic disorder and depression. Moreover, obsessive-compulsive and schizotypal personality disorders are over-represented in OCD. These may constitute misperceived clinical manifestations of ASD. Furthermore, repetitive behaviours and hoarding are common in Asperger syndrome. It is suggested that the comorbidity results in a more severe and treatment resistant form of OCD. OCD with comorbid ASD should be recognized as a valid OCD subtype, analogous to OCD with comorbid tics. An odd personality, with paranoid, schizotypal, avoidant or obsessive-compulsive traits, may indicate these autistic dimensions in OCD patients.
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Mathews CA, Uhm S, Chan J, Gause M, Franklin J, Plumadore J, Stark SJ, Yu W, Vigil O, Salazar M, Delucchi KL, Vega E. Treating Hoarding Disorder in a real-world setting: Results from the Mental Health Association of San Francisco. Psychiatry Res 2016; 237:331-8. [PMID: 26805562 PMCID: PMC6020681 DOI: 10.1016/j.psychres.2016.01.019] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2015] [Revised: 12/03/2015] [Accepted: 01/11/2016] [Indexed: 11/27/2022]
Abstract
Hoarding Disorder (HD) is associated with substantial distress, impairment, and individual and societal costs. Cognitive-behavioral therapy (CBT) tailored to HD is the best-studied form of treatment and can be led by mental health professionals or by non-professionals (peers) with specific training. No previous study has directly compared outcomes for therapist-led and peer-led groups, and none have examined the effectiveness of these groups in a real-world setting. We used retrospective data to compare psychologist-led CBT groups (G-CBT) to groups led by peer facilitators using the Buried in Treasures workbooks (G-BiT) in individuals who sought treatment for HD from the Mental Health Association of San Francisco. The primary outcome was change in Hoarding Severity Scale scores. Approximate costs per participant were also examined. Both G-CBT and G-BiT showed improvement consistent with previous reports (22% improvement overall). After controlling for baseline group characteristics, there were no significant differences in outcomes between G-CBT and G-BiT. For G-CBT, where additional outcome data were available, functional impairment and severity of hoarding symptoms improved to a similar degree as compared to previous G-CBT studies, while hoarding-related cognition improved to a lesser degree (also consistent with previous studies). G-BiT cost approximately $100 less per participant than did G-CBT.
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Affiliation(s)
- Carol A. Mathews
- Department of Psychiatry, University of Florida, Gainesville, Florida, USA; aDepartment of Psychiatry, University of California, San Francisco, California, USA,Correspondence to Carol A Mathews, 100 S. Newell Dr, L4-100, Gainesville, FL 32610;
| | - Soo Uhm
- Department of Psychiatry, University of Florida, Gainesville, Florida, USA; aDepartment of Psychiatry, University of California, San Francisco, California, USA
| | - Joanne Chan
- Mental Health Association of San Francisco, San Francisco, California, USA
| | - Michael Gause
- Mental Health Association of San Francisco, San Francisco, California, USA
| | - John Franklin
- Mental Health Association of San Francisco, San Francisco, California, USA
| | - Julian Plumadore
- Mental Health Association of San Francisco, San Francisco, California, USA
| | - Sandra J. Stark
- Mental Health Association of San Francisco, San Francisco, California, USA
| | - Wendy Yu
- Mental Health Association of San Francisco, San Francisco, California, USA
| | - Ofilio Vigil
- Department of Psychiatry, University of Florida, Gainesville, Florida, USA; aDepartment of Psychiatry, University of California, San Francisco, California, USA
| | - Mark Salazar
- Mental Health Association of San Francisco, San Francisco, California, USA
| | - Kevin L. Delucchi
- Department of Psychiatry, University of Florida, Gainesville, Florida, USA; aDepartment of Psychiatry, University of California, San Francisco, California, USA
| | - Eduardo Vega
- Mental Health Association of San Francisco, San Francisco, California, USA
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Vickers BD, Preston SD, Gonzalez R, Angott AM. Hoarders Only Discount Consumables and Are More Patient for Money. Front Behav Neurosci 2016; 10:30. [PMID: 26973479 PMCID: PMC4777727 DOI: 10.3389/fnbeh.2016.00030] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2015] [Accepted: 02/08/2016] [Indexed: 11/29/2022] Open
Abstract
Individuals with hoarding disorder (HD) excessively acquire and retain goods while also exhibiting characteristics of impulsivity and addiction. However, HD individuals do not always perform impulsively in experiments, they do not appear interested in money, and they exhibit many features of risk-aversion and future-planning. To examine impulsivity in HD, we compared validated community participants high and low in hoarding tendencies on questionnaire measures of hoarding and impulsivity as well as a standard experimental measure of impulsivity (intertemporal discounting) that was modified to compare decisions about money, pens, and snacks. Common discounting effects were replicated. Compared to the low hoarding group, the high hoarding group was more impatient for consumables (pens and snacks) but they were more patient for money. This increased patience for money in high hoarding individuals is in contrast to all other studies on discounting in disordered populations, but consistent with the phenomenology of HD. HD does not appear to be driven by a fundamental inability to wait, but rather a specific, potent desire for consumable rewards.
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Affiliation(s)
- Brian D Vickers
- Department of Psychology, University of Michigan, Ann Arbor MI, USA
| | | | - Richard Gonzalez
- Department of Psychology, University of Michigan, Ann Arbor MI, USA
| | - Andrea M Angott
- Department of Psychology, University of Michigan, Ann Arbor MI, USA
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López-Solà C, Fontenelle LF, Verhulst B, Neale MC, Menchón JM, Alonso P, Harrison BJ. DISTINCT ETIOLOGICAL INFLUENCES ON OBSESSIVE-COMPULSIVE SYMPTOM DIMENSIONS: A MULTIVARIATE TWIN STUDY. Depress Anxiety 2016; 33:179-91. [PMID: 26630089 PMCID: PMC4775288 DOI: 10.1002/da.22455] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2015] [Revised: 10/15/2015] [Accepted: 11/01/2015] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Obsessive-compulsive disorder (OCD) is characterized by five major dimensions, including contamination/washing, harm/checking, symmetry/ordering, hoarding, and forbidden thoughts. How these dimensions may relate etiologically to the symptoms of other obsessive-compulsive related disorders (OCRDs) and anxiety disorders (ADs) is not well known. The aim of this study was to examine the genetic and environmental overlap between each major obsessive-compulsive dimension with the symptoms of other OCRDs and ADs. METHODS Two thousand four hundred ninety-five twins of both sexes, aged between 18 and 45 years, were recruited from the Australian Twin Registry. Measures used scores on four dimensions (obsessing (forbidden thoughts), washing, checking, and ordering) of the Obsessive-Compulsive Inventory-Revised, Dysmorphic Concerns Questionnaire, Hoarding Rating Scale, Anxiety Sensitivity Index, Social Phobia Inventory, and Stress subscale of the Depression, Anxiety, and Stress Scale. Multivariate twin modeling methods using continuous and categorized variables were performed, also controlling for age and gender. RESULTS Our findings suggested that forbidden thoughts and washing demonstrated the strongest genetic overlap with other AD symptoms, while ordering was genetically related to OCRD symptoms. Common genetic influences on checking symptoms were best estimated when modeling OCRDs together with AD symptoms. Common environmental factors of ordering and checking were shared with AD symptoms. CONCLUSIONS Important shared genetic and environmental risk factors exist between OCD, OCRDs, and ADs, but which vary alongside the expression of its major dimensions.
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Affiliation(s)
- Clara López-Solà
- Department of Psychiatry, Bellvitge Biomedical Research Institute—IDIBELL, Bellvitge University Hospital, CIBERSAM (G17), Barcelona, Spain,Department of Clinical Sciences, Bellvitge Campus, University of Barcelona, Barcelona, Spain
| | - Leonardo F. Fontenelle
- Programa de Transtornos Obsessivo-Compulsivos e de Ansiedade, Instituto de Psiquiatria, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brazil,lnstituto D’Or de Pesquisa e Ensino (IDOR), Rio de Janeiro, RJ, Brazil,Instituto de Saúde da Comunidade, Universidade Federal Fluminense (UFF), Rio de Janeiro, RJ, Brazil
| | - Brad Verhulst
- Virginia Institute for Psychiatric and Behavioral Genetics (VIPBG), Virginia Commonwealth University, Richmond, Virginia
| | - Michael C. Neale
- Virginia Institute for Psychiatric and Behavioral Genetics (VIPBG), Virginia Commonwealth University, Richmond, Virginia
| | - José M. Menchón
- Department of Psychiatry, Bellvitge Biomedical Research Institute—IDIBELL, Bellvitge University Hospital, CIBERSAM (G17), Barcelona, Spain,Department of Clinical Sciences, Bellvitge Campus, University of Barcelona, Barcelona, Spain
| | - Pino Alonso
- Department of Psychiatry, Bellvitge Biomedical Research Institute—IDIBELL, Bellvitge University Hospital, CIBERSAM (G17), Barcelona, Spain,Department of Clinical Sciences, Bellvitge Campus, University of Barcelona, Barcelona, Spain
| | - Ben J. Harrison
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne, Melbourne, Australia,Correspondence: Ben J. Harrison, Melbourne Neuropsychiatry Centre, The University of Melbourne, Level 3, 161 Barry Street, Carlton, 3053 Melbourne, Australia.
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Clinical Correlates of Hoarding With and Without Comorbid Obsessive-Compulsive Symptoms in a Community Pediatric Sample. J Am Acad Child Adolesc Psychiatry 2016; 55:114-21.e2. [PMID: 26802778 DOI: 10.1016/j.jaac.2015.11.014] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2015] [Revised: 11/06/2015] [Accepted: 11/20/2015] [Indexed: 11/22/2022]
Abstract
OBJECTIVE We assessed the prevalence and clinical correlates of hoarding, with and without obsessive-compulsive (OC) symptoms, in a community-based pediatric sample. METHOD We measured hoarding and OC symptoms using the Toronto Obsessive-Compulsive Scale (TOCS) in 16,718 youth aged 6 to 17 years in the community. We classified participants with high and low symptom counts for hoarding and OC into 4 groups: hoarding+OC; hoarding-only; OC-only; and control (no OC or hoarding symptoms). We compared these 4 groups on parent- or self-reported medical and psychiatric conditions, anxiety symptoms measured with the Child Behavior Checklist (CBCL), and attention-deficit/hyperactivity disorder (ADHD) symptoms measured with the Strengths and Weaknesses of Attention-Deficit/Hyperactivity Disorder Symptoms and Normal Behavior Scale (SWAN). RESULTS Almost 10% of participants were in the high hoarding group. Of these participants, 40% did not fall into the high OC group. The prevalence of reported psychiatric disorders (e.g., ADHD, autism spectrum disorder, obsessive-compulsive disorder) was greater in the hoarding (hoarding+OC and hoarding-only) and OC groups (hoarding+OC and OC-only) than in the nonhoarding (OC-only and control) and non-OC groups (hoarding-only and control), respectively. ADHD, specifically inattentive, symptoms were more common in the hoarding-only than in the OC-only group while anxiety symptoms were more common in the OC-only than in the hoarding-only group. CONCLUSION In a community pediatric sample, hoarding symptoms occurred in both the presence and absence of obsessive-compulsive symptoms. Hoarding symptoms alone had some unique clinical correlates, in particular, more inattentive ADHD symptoms and fewer anxiety symptoms. These findings suggest that hoarding is distinct from OC traits in youth.
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Riddle MA, Maher BS, Wang Y, Grados M, Bienvenu OJ, Goes FS, Cullen B, Murphy DL, Rauch SL, Greenberg BD, Knowles JA, McCracken JT, Pinto A, Piacentini J, Pauls DL, Rasmussen SA, Shugart YY, Nestadt G, Samuels J. OBSESSIVE-COMPULSIVE PERSONALITY DISORDER: EVIDENCE FOR TWO DIMENSIONS. Depress Anxiety 2016; 33:128-35. [PMID: 26594839 DOI: 10.1002/da.22452] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2015] [Revised: 09/23/2015] [Accepted: 10/18/2015] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND To determine possible dimensions that underlie obsessive-compulsive personality disorder (OCPD) and to investigate their clinical correlates, familiality, and genetic linkage. METHODS Participants were selected from 844 adults assessed with the Structured Instrument for the Diagnosis of DSM-IV Personality Disorders (SIDP) in the OCD Collaborative Genetics Study (OCGS) that targeted families with obsessive-compulsive disorder (OCD) affected sibling pairs. We conducted an exploratory factor analysis, which included the eight SIDP-derived DSM-IV OCPD traits and the indecision trait from the DSM-III, assessed clinical correlates, and estimated sib-sib correlations to evaluate familiality of the factors. Using MERLIN and MINX, we performed genome-wide quantitative trait locus (QTL) linkage analysis to test for allele sharing among individuals. RESULTS Two factors were identified: Factor 1: order/control (perfectionism, excessive devotion to work, overconscientiousness, reluctance to delegate, and rigidity); and Factor 2: hoarding/indecision (inability to discard and indecisiveness). Factor 1 score was associated with poor insight, whereas Factor 2 score was associated with task incompletion. A significant sib-sib correlation was found for Factor 2 (rICC = .354, P < .0001) but not Factor 1 (rICC = .129, P = .084). The linkage findings were different for the two factors. When Factor 2 was analyzed as a quantitative trait, a strong signal was detected on chromosome 10 at marker d10s1221: KAC LOD = 2.83, P = .0002; and marker d10s1225: KAC LOD = 1.35, P = .006. CONCLUSIONS The results indicate two factors of OCPD, order/control and hoarding/indecision. The hoarding/indecision factor is familial and shows modest linkage to a region on chromosome 10.
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Affiliation(s)
- Mark A Riddle
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Brion S Maher
- Department of Mental Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland
| | - Ying Wang
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Marco Grados
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - O Joseph Bienvenu
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Fernando S Goes
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Bernadette Cullen
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Dennis L Murphy
- Laboratory of Clinical Science, National Institute of Mental Health, National Institute of Health, Bethesda, Maryland
| | - Scott L Rauch
- Department of Psychiatry, McLean Hospital, Harvard Medical School, Boston, Massachusetts
| | - Benjamin D Greenberg
- Department of Psychiatry and Human Behavior, Brown Medical School, Butler Hospital, Providence, Rhode Island
| | - James A Knowles
- Department of Psychiatry, University of Southern California School of Medicine, Los Angeles, California
| | - James T McCracken
- Department of Psychiatry and Biobehavioral Sciences, School of Medicine, University of California Los Angeles, Los Angeles, California
| | - Anthony Pinto
- Department of Psychiatry, Columbia University College of Physicians and Surgeons, New York State Psychiatric Institute, New York City, New York
| | - John Piacentini
- Department of Psychiatry and Biobehavioral Sciences, School of Medicine, University of California Los Angeles, Los Angeles, California
| | - David L Pauls
- Department of Psychiatry, Psychiatric and Neurodevelopmental Genetics Unit, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Steven A Rasmussen
- Department of Psychiatry and Human Behavior, Brown Medical School, Butler Hospital, Providence, Rhode Island
| | - Yin Yao Shugart
- Unit of Statistical Genomics, Division of Intramural Research, National Institute of Mental Health, National Institute of Health, Bethesda, Maryland
| | - Gerald Nestadt
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Jack Samuels
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland
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Williams M, Viscusi JA. Hoarding Disorder and a Systematic Review of Treatment with Cognitive Behavioral Therapy. Cogn Behav Ther 2016; 45:93-110. [DOI: 10.1080/16506073.2015.1133697] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Comorbidity variation in patients with obsessive-compulsive disorder according to symptom dimensions: Results from a large multicentre clinical sample. J Affect Disord 2016; 190:508-516. [PMID: 26561941 DOI: 10.1016/j.jad.2015.10.051] [Citation(s) in RCA: 66] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2015] [Revised: 09/17/2015] [Accepted: 10/27/2015] [Indexed: 11/23/2022]
Abstract
BACKGROUND Obsessive-compulsive disorder (OCD) has a heterogeneous and complex phenomenological picture, characterized by different symptom dimensions and comorbid psychiatric disorders, which frequently co-occur or are replaced by others over the illness course. To date, very few studies have investigated the associations between specific OCD symptom dimensions and comorbid disorders. METHODS Cross-sectional, multicenter clinical study with 1001 well-characterized OCD patients recruited within the Brazilian Research Consortium on Obsessive-Compulsive and Related Disorders. The primary instruments were the Dimensional Yale-Brown Obsessive Compulsive Scale (DY-BOCS) and the Structured Clinical Interview for DSM-IV Axis I Disorders. Bivariate analyses between symptom dimensions and comorbidities were followed by logistic regression. RESULTS The most common comorbidities among participants (56.8% females) were major depression (56.4%), social phobia (34.6%), generalized anxiety disorder (34.3%), and specific phobia (31.4%). The aggressive dimension was independently associated with posttraumatic stress disorder (PTSD), separation anxiety disorder, any impulse-control disorder and skin picking; the sexual-religious dimension was associated with mood disorders, panic disorder/agoraphobia, social phobia, separation anxiety disorder, non-paraphilic sexual disorder, any somatoform disorder, body dysmorphic disorder and tic disorders; the contamination-cleaning dimension was related to hypochondriasis; and the hoarding dimension was associated with depressive disorders, specific phobia, PTSD, impulse control disorders (compulsive buying, skin picking, internet use), ADHD and tic disorders. The symmetry-ordering dimension was not independently associated with any comorbidity. LIMITATIONS Cross-sectional design; participants from only tertiary mental health services; personality disorders not investigated. CONCLUSIONS Different OCD dimensions presented some specific associations with comorbid disorders, which may influence treatment seeking behaviors and response, and be suggestive of different underlying pathogenic mechanisms.
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Zilhão NR, Smit DJ, Boomsma DI, Cath DC. Cross-Disorder Genetic Analysis of Tic Disorders, Obsessive-Compulsive, and Hoarding Symptoms. Front Psychiatry 2016; 7:120. [PMID: 27445875 PMCID: PMC4928649 DOI: 10.3389/fpsyt.2016.00120] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2016] [Accepted: 06/20/2016] [Indexed: 11/13/2022] Open
Abstract
Hoarding, obsessive-compulsive disorder (OCD), and Tourette's disorder (TD) are psychiatric disorders that share symptom overlap, which might partly be the result of shared genetic variation. Population-based twin studies have found significant genetic correlations between hoarding and OCD symptoms, with genetic correlations varying between 0.1 and 0.45. For tic disorders, studies examining these correlations are lacking. Other lines of research, including clinical samples and GWAS or CNV data to explore genetic relationships between tic disorders and OCD, have only found very modest if any shared genetic variation. Our aim was to extend current knowledge on the genetic structure underlying hoarding, OC symptoms (OCS), and lifetime tic symptoms and, in a trivariate analysis, assess the degree of common and unique genetic factors contributing to the etiology of these disorders. Data have been gathered from participants in the Netherlands Twin Register comprising a total of 5293 individuals from a sample of adult monozygotic (n = 2460) and dizygotic (n = 2833) twin pairs (mean age 33.61 years). The data on Hoarding, OCS, and tic symptoms were simultaneously analyzed in Mplus. A liability threshold model was fitted to the twin data, analyzing heritability of phenotypes and of their comorbidity. Following the criteria for a probable clinical diagnosis in all phenotypes, 6.8% of participants had a diagnosis of probable hoarding disorder (HD), 6.3% of OCS, and 12.8% of any probable lifetime tic disorder. Genetic factors explained 50.4, 70.1, and 61.1% of the phenotypic covariance between hoarding-OCS, hoarding-tics, and OCS-tics, respectively. Substantial genetic correlations were observed between hoarding and OCS (0.41), hoarding and tics (0.35), and between OCS and tics (0.37). These results support the contribution of genetic factors in the development of these disorders and their comorbidity. Furthermore, tics were mostly influenced by specific environmental factors unshared with OCS and HD.
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Affiliation(s)
- Nuno R Zilhão
- Department of Clinical and Health Psychology, Utrecht University, Utrecht, Netherlands; Department of Biological Psychology, Vrije Universiteit, Amsterdam, Netherlands
| | - Dirk J Smit
- Department of Biological Psychology, Vrije Universiteit, Amsterdam, Netherlands; Neuroscience Campus Amsterdam, Vrije Universiteit, Amsterdam, Netherlands
| | - Dorret I Boomsma
- Department of Biological Psychology, Vrije Universiteit , Amsterdam , Netherlands
| | - Danielle C Cath
- Department of Clinical and Health Psychology, Utrecht University, Utrecht, Netherlands; Altrecht Academic Anxiety Center, Utrecht, Netherlands
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