Characterizing the hoarding phenotype in individuals with OCD: Associations with comorbidity, severity and gender

Laboratory of Clinical Science, National Institute of Mental Health, USA.
Journal of Anxiety Disorders (Impact Factor: 2.96). 02/2008; 22(2):243-52. DOI: 10.1016/j.janxdis.2007.01.015
Source: PubMed


Hoarding frequently occurs in obsessive-compulsive disorder (OCD), and some evidence suggests that it constitutes a distinct OCD subtype, with genetic contributions. This study investigated differences between OCD patients with and without hoarding symptoms. Of the 473 OCD patients studied, 24% were classified as hoarders according to combined interviewer and self-ratings, which were validated with the Savings Inventory-Revised in a subsample. Hoarders suffered from significantly more severe OCD symptoms, (especially compulsions) and had greater impairment and dysphoria. Hoarders also had more comorbid psychiatric disorders. Further study revealed that many of these differences were attributable to the female subjects: Compared to female non-hoarders, female hoarders were more likely to suffer from bipolar I, substance abuse, panic disorder, binge-eating disorder, and had greater OCD severity. Male hoarders had an increased prevalence of social phobia compared to non-hoarding males. These results suggest that there are gender-specific differences in the hoarding sub-phenotype of OCD.

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Available from: Kiara R Timpano
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    • "Research has found that obsessive–compulsive disorder (OCD) patients who hoard experience higher levels of Contents lists available at ScienceDirect journal homepage: psychopathology (e.g., anxiety symptoms, lifetime suicidal attempts ), worse functioning, and greater disability than patients with only OCD symptoms (Chakraborty et al., 2012;Frost, Steketee, Williams, & Warren, 2000;Samuels et al., 2002;Wheaton, Timpano, Lasalle-Ricci, & Murphy, 2008). Furthermore, among patients with anxiety disorders, hoarding symptoms were significantly correlated with family impairment, above and beyond the effects of depression (Tolin et al., 2011). "
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    ABSTRACT: Hoarding symptoms commonly co-occur with other psychiatric disorders, such as major depressive disorder, and have been observed across cultures. Yet, few studies have examined hoarding in other disorders or in an Asian context. The present study aimed to determine: (1) the prevalence of clinically significant hoarding, (2) differences between participants with and without significant hoarding, and (3) predictors of hoarding severity in a Singaporean clinical sample. Five hundred outpatients with anxiety disorders, depressive disorders, schizophrenia, and pathological gambling completed a battery of questionnaires on hoarding, anxiety, depression, functional impairment due to clutter, and quality of life. Thirty percent of our sample reported significant hoarding. However, clutter levels in the hoarding group were low, and hoarding severity was not significantly linked to quality of life, after adjusting for anxiety and depression. In addition, depression - but not anxiety - predicted hoarding severity. Our results provide a cross-cultural perspective on hoarding symptoms, and replicate findings that support a link between depression and hoarding. The differential presentation of hoarding in our sample could be due to true cultural differences in hoarding pathology or to variant psychometric properties of the measures used. Further research evaluating hoarding in Asian contexts with different methodology is needed.
    Full-text · Article · Dec 2015 · Journal of Obsessive-Compulsive and Related Disorders
    • "Specifically, while some studies found that hoarding was associated with a significantly earlier age of onset (Fontenelle, Mendlowicz, Soares, & Versiani, 2004), other studies did not find this difference (e.g.,Wheaton, Timpano, LaSalle-Ricci, & Murphy, 2008). Likewise, while some researchers found significantly increased OC symptom severity in hoarders than nonhoarders (e.g.,Wheaton et al., 2008) other investigators did not find this discrepancy (e.g.,Neziroglu, Weissman, Allen, & McKay, 2012). Numerous studies examined potential differences in TR between hoarders and nonhoarders. "
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    ABSTRACT: The purpose of this review was to assess the validity of proposed obsessive-compulsive disorder (OCD) subtypes by utilizing Robins and Guze's (1970) five guidelines for developing subtypes: (1) clinical description, (2) follow-up studies, (3) laboratory studies, (4) delimitation from other disorders, and (5) family studies, and an additional (6) treatment response guideline. Accordingly, a review of the literature was conducted focusing on these guidelines. The resulting studies showed that, when utilizing these criteria, there is no operationally valid OCD subtype. Although most proposed subtypes had sufficient research conducted on them, none of them met all six of the guidelines. Although seven proposed subtypes met all of the guidelines that had been examined within them, additional research is required to assess whether they constitute valid subtypes.
    No preview · Article · Dec 2015 · Clinical Psychology Science and Practice
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    • "In a study of 418 participants (Hasler et al., 2007), aggressive, sexual and religious obsessions, and checking compulsions were linked to affective disorders, whereas symmetry, ordering and arranging compulsions were associated with attention deficit hyperactivity disorder (ADHD), alcohol dependence and bulimia nervosa. The symmetry-ordering dimension has also been previously associated with tic disorders (Miguel et al., 1997; Coffey et al., 1998), whereas the hoarding dimension has been linked to depressive (Winsberg et al., 1999; Coles et al., 2003; Frost et al., 2011; Tolin and Villavicencio , 2011; Hall et al., 2013) and bipolar disorders (Fontenelle et al., 2004; LaSalle-Ricci et al., 2006; Samuels et al., 2007; Wheaton et al., 2008; Chakraborty et al., 2012), generalized anxiety disorder (GAD; Samuels et al., 2007; Chakraborty et al., 2012), panic disorder (Storch et al., 2007; Samuels et al., 2014), specific phobia (Samuels et al., 2014), social phobia (Coles et al., 2003; Samuels et al., 2007; Wheaton et al., 2008), BDD (LaSalle-Ricci et al., 2006; Samuels et al., 2007), substance use disorders (Wheaton et al., 2008), tic disorders (Samuels et al., 2007; 2014), ADHD (Hartl et al., 2005; Tolin and Villavicencio, 2011, Hacker et al., 2012; Frank et al., 2014), posttraumatic stress disorder (PTSD; LaSalle-Ricci et al., 2006) and impulse-control disorders (ICD; Winsberg et al., 1999; Grisham et al., 2007; Tolin and Villavicencio, 2011; Timpano et al., 2014), particularly " grooming behaviors " (Samuels et al., 2002, 2007), compulsive buying (Winsberg et al., 1999; Mueller et al., 2009; Frost et al., 2009, 2011; Bulli et al., 2014) and kleptomania (Frost et al., 2011). Despite the relevant contributions of these above studies, several methodological limitations exist. "
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    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.
    Full-text · Article · Nov 2015 · Journal of Affective Disorders
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