PubMed Health⌕ Search

SEARCH · PubMed Health

Results for “Hoarding Disorder”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 91 records · Page 5Linked to original sources

Symptom subtypes of obsessive-compulsive disorder in behavioral treatment studies: a quantitative review.

Recent reviews and meta-analytic studies have provided an encouraging account of the effectiveness of behavioral interventions for obsessive-compulsive disorder (OCD). One question regarding these estimates concerns their degree of generalizability to the range of OCD subtypes encountered in clinical settings. The purpose of the present study was to provide a quantitative description of the prevalence of various OCD subtypes (i.e. type of compulsions) within the behavioral treatment literature. We examined 65 studies that permitted classification of patients according to symptom subtype. Patients with primarily cleaning and/or checking compulsions predominated, accounting for 75% of the treatment population. On the other hand, patients with multiple compulsions or other compulsions, such as exactness, counting, hoarding, or slowness rituals were underrepresented, comprising only 12% of the population, which is markedly less than clinical epidemiological estimates. Rates of improvements in patients with OCD are most applicable to patients with cleaning and checking compulsions, but may not yet be generalizable to patients with other symptoms. These findings encourage studies of the efficacy of existing and novel interventions for patients with counting, repeating, symmetry, hoarding, or multiple compulsions in order to broaden the clinical application of OCD behavioral treatment.

Behavior Therapy↗

Metabolic and hormonal control of the desire for food and sex: implications for obesity and eating disorders.

During evolution, the ability to overeat and store the extra energy as glycogen and lipids in specialized tissues must have conferred a reproductive advantage by releasing animals from the need to eat constantly, enabling them to engage in behaviors that improved reproductive success. Mechanisms that inhibited ingestive behavior might have been most adaptive when they caused individuals to stop foraging, hoarding and eating in order to find and court potential mates. Conversely, the ability to abstain from reproductive activities to engage in foraging and eating was probably critical for individual survival during severe energetic challenges because reproductive processes are energetically costly and can be delayed until the energetic conditions improve. The mechanisms that control ingestive behavior most likely evolved under conditions in which both food and mates were available, and thus, our understanding might be limited by our narrow focus on food intake in animals isolated from potential mates, and reproductive behaviors in the absence of food. Our understanding of obesity and eating disorders will be enriched by the study of the choice between ingestive and reproductive behaviors and by a renewed attention to "reproductive" hormones such as gonadal steroids and hypothalamic releasing hormones. Furthermore, leptin and reproductive hormones have both organizational and activational effects on the energy balancing system including those mechanisms that control appetite, body fat content and body fat distribution. Understanding these organizational and activational effects on body fat distribution might lead to a better understanding of sex differences in the propensity to develop obesity, type II diabetes and eating disorders.

Animals↗

[Kleptomania: clinical and legal aspects].

Kleptomania is characterized by repetitive and irresistible impulses to steal objects, with growing excitement before, and relief after the incidents. The thefts are not planned, carried out without confidants and regarded as illegal by the offenders who often feel guilty for it. The objects are stolen not for monetary gain or personal use, but are mostly discarded, given away or hoarded. Though there is a debate going on for more than 100 years, the nosological position of kleptomania remains unclear. On the one hand the clinical picture is observed as an isolated disorder in otherwise healthy persons, on the other hand it may also occur as an accompanying symptom of various other psychiatric disorders, e. g. impulse control disorders, acute psychoses, affective, or organic psychic disorders. The present article gives an overview of the most important aetiopathogenetic viewpoints about kleptomania and discusses their nosological, therapeutical and legal implications.

Crime↗

Symptom presentation and outcome of cognitive-behavioral therapy for obsessive-compulsive disorder.

Previous researchers have classified obsessive-compulsive disorder (OCD) patients by the themes of their obsessions and compulsions (e.g., washing, checking); however, mental compulsions have not been adequately assessed in these studies. The authors conducted 2 studies using a large sample of OCD patients (N=132). In the 1st study, they categorized patients on the basis of symptom presentation, giving adequate consideration to mental compulsions. Five patient clusters were identified: harming, contamination, hoarding, unacceptable thoughts, and symmetry. Mental compulsions were most prevalent among patients with intrusive, upsetting religious, violent, or sexual thoughts. In the 2nd study, they compared response to cognitive-behavioral therapy across symptom categories, finding poorer outcomes among patients with hoarding symptoms compared with those with other symptom themes.

Adolescent↗

Could obsessive-compulsive disorder have originated as a group-selected adaptive trait in traditional societies?

Obsessive-compulsive disorder (OCD) possesses distinctive characteristics inviting evolutionary and anthropological explanations. A genetically based condition with low fecundity persisting through generations is paradoxical. The concept of group selection is an evolutionary principle capable of clarifying the perplexing epidemiology of OCD. Using a group-selection paradigm, the authors propose that OCD reflects an ancient form of behavioural specialization. The majority of compulsions such as checking, washing, counting, needing to confess, hoarding and requiring precision, all carry the potential to benefit society. Focussing primarily on hunting and gathering cultures, the potential evolutionary advantages of OCD are explored.

Adaptation, Biological↗

Factor analysis of obsessive-compulsive disorder YBOCS-SC symptoms and association with 5-HTTLPR SERT polymorphism.

Symptoms defining obsessive-compulsive disorder (OCD) are diverse. Factor analyses of OCD symptoms have been used to evaluate obsessive-compulsive phenotypes that are thought to be more homogenous than the macro phenotype. There is evidence that three factors (symmetry/ordering, obsessions/checking, and hoarding) are familial and preliminary evidence that repetitive rituals are associated with a functional polymorphism in the promotor region of the serotonin transporter gene (5-HTTLPR). The goal of this study was to examine relationships between OCD symptom dimensions and 5-HTTLPR. We genotyped 153 subjects who met DSM-IV criteria for OCD. We used the Yale-Brown obsessive-compulsive scale symptom checklist (YBOCS-SC) to assess OCD symptoms. Using principle components analysis, we derived four factors from the 13 symptom categories of the YBOCS-SC in this patient sample, which replicated previous factor analyses of this scale. The frequencies of the S allele and the SS genotype were associated with the second factor including obsessions regarding symmetry and compulsions involving repeating, counting, and ordering/arranging. This study may contribute to understanding of molecular genetic features underlying the appearance of symptom clusters in OCD.

Adult↗

Ma1, a novel neuron- and testis-specific protein, is recognized by the serum of patients with paraneoplastic neurological disorders.

The identification of antineuronal antibodies has facilitated the diagnosis of paraneoplastic neurological disorders and the early detection of the associated tumours. It has also led to the cloning of possibly important neuron-specific proteins. In this study we wanted to identify novel antineuronal antibodies in the sera of patients with paraneoplastic neurological disorders and to clone the corresponding antigens. Serological studies of 1705 sera from patients with suspected paraneoplastic neurological disorders resulted in the identification of four patients with antibodies that reacted with 37 and 40 kDa neuronal proteins (anti-Ma antibodies). Three patients had brainstem and cerebellar dysfunction, and one had dysphagia and motor weakness. Autopsy of two patients showed loss of Purkinje cells, Bergmann gliosis and deep cerebellar white matter inflammatory infiltrates. Extensive neuronal degeneration, gliosis and infiltrates mainly composed of CD8+ T cells were also found in the brainstem of one patient. In normal human and rat tissues, the anti-Ma antibodies reacted exclusively with neurons and with testicular germ cells; the reaction was mainly with subnuclear elements (including the nucleoli) and to a lesser degree the cytoplasm. Anti-Ma antibodies also reacted with the cancers (breast, colon and parotid) available from three anti-Ma patients, but not with 66 other tumours of varying histological types. Preincubation of tissues with any of the anti-Ma sera abrogated the reactivity of the other anti-Ma immunoglobulins. Probing of a human complementary DNA library with anti-Ma serum resulted in the cloning of a gene that encodes a novel 37 kDa protein (Mal). Recombinant Mal was specifically recognized by the four anti-Ma sera but not by 337 control sera, including those from 52 normal individuals, 179 cancer patients without paraneoplastic neurological symptoms, 96 patients with paraneoplastic syndromes and 10 patients with non-cancer-related neurological disorders. The expression of Mal mRNA is highly restricted to the brain and testis. Subsequent analysis suggested that Mal is likely to be a phosphoprotein. Our study demonstrates that some patients with paraneoplastic neurological disorders develop antibodies against Mal, a new member of an expanding family of 'brain/testis' proteins.

Amino Acid Sequence↗

Pathophysiology of obsessive-compulsive disorder: a necessary link between phenomenology, neuropsychology, imagery and physiology.

Obsessive-compulsive disorder (OCD) is characterized by repetitive intrusive thoughts and compulsive time-consuming behaviors classified into three to five distinct symptom dimensions including: (1) aggressive/somatic obsessions with checking compulsions; (2) contamination concerns with washing compulsions; (3) symmetry obsessions with counting/ordering compulsions; (4) hoarding obsessions with collecting compulsions; and (5) sexual/religious concerns. Phenomenologically, OCD could be thought of as the irruption of internal signals centered on the erroneous perception that "something is wrong" in a specific situation. This generates severe anxiety, leading to recurrent behaviors aimed at reducing the emotional tension. In this paper, we examine how the abnormalities in brain activity reported in OCD can be interpreted in the light of physiology after consideration of various approaches (phenomenology, neuropsychology, neuroimmunology and neuroimagery) that contribute to proposing the central role of several cortical and subcortical regions, especially the orbitofrontal cortex (OFC), the anterior cingulate cortex (ACC), the dorsolateral prefrontal cortex (DLPC), the head of the caudate nucleus and the thalamus. The OFC is involved in the significance attributed to the consequences of action, thereby subserving decision-making, whereas the ACC is particularly activated in situations in which there are conflicting options and a high likelihood of making an error. The DLPC plays a critical part in the cognitive processing of relevant information. This cortical information is then integrated by the caudate nucleus, which controls behavioral programs. A dysfunction of these networks at one or several stages will result in the emergence and maintenance of repetitive thoughts and characteristic OCD behavior.

Diagnostic Imaging↗

Hoarding of animals: an under-recognized public health problem in a difficult-to-study population.

OBJECTIVE: The objective of this study was to better characterize the problem of hoarding, or pathological collecting, of animals. METHODS: The author summarized data from a convenience sample of 54 case reports from 10 animal control agencies and humane societies across the country. RESULTS: The majority (76%) of hoarders were female, and 46% were 60 years of age or older. About half of the hoarders lived in single-person households. The animals most frequently involved were cats, dogs, farm animals, and birds. The median number of animals per case was 39, but there were four cases of more than 100 animals in a household. In 80% of cases animals were reportedly found dead or in poor condition. Prevalence estimates extrapolated from these data range from 700 to 2000 U.S. cases annually. CONCLUSIONS: Public health authorities should recognize that animal hoarding may be a sentinel for mental health problems or dementia, which merit serious assessment and prompt intervention. Improved cooperation between humane societies and public health authorities could facilitate the resolution of animal hoarding cases.

Animal Welfare↗

Symptom subtypes of obsessive-compulsive disorder and their relation to dissociation.

We examined relations between obsessive-compulsive disorder (OCD) symptoms and dissociation in three studies. Studies 1 and 2 established a strong level of convergence between our two OCD symptom measures. Specific types of symptoms showed a clear convergent/discriminant pattern, indicating that they can be meaningfully distinguished from one another. In both studies, dissociation correlated more strongly with checking and obsessive intrusions than with cleaning, ordering, and hoarding. Moreover, these associations remained substantial even after controlling for neuroticism (Study 1) and other types of anxiety (Study 2). In Study 3, we replicated our key findings in a psychiatric outpatient sample, indicating that they are generalizable to clinical participants. Taken together, our results (a) establish a strong link between dissociation and OCD, and (b) illustrate the importance of analyzing different types of OCD symptoms separately.

Adult↗

Obsessive-compulsive disorder subgroups: a symptom-based clustering approach.

Although obsessive-compulsive disorder (OCD) is often considered a heterogeneous condition, there is no generally accepted subtype typology. Cluster analysis was used to identify definitive symptom-based groupings of 106 OCD patients. A stable cluster solution was achieved and five patient subgroups were identified based on their pattern of symptoms on the Yale-Brown (Y-BOCS) symptom checklist: harming, hoarding, contamination, certainty and obsessionals. The five subgroups were characterized by dominant symptom patterns and significant secondary concerns reflecting the symptom heterorgenaity often seen in the clinical presentation of obsessional patents. Between cluster differences on multiple symptom measures were evaluated and several meaningful differences were identified. Cluster analytic procedures may prove to be a useful tool for identifying a functional taxonomy of OCD subtypes.

Adult↗

Drug hoarding in a rural community in Israel. Results of a pilot epidemiologic investigation.

The total quantity of drugs hoarded in a rural village in Israel was established as a result of a comprehensive house-to-house search. In 43 of the 44 houses in the village, hoarded drugs were found. The average number of different drugs found per household was 15.5 and the median number, 9.5. Analgesic and antipyretic drugs, topical skin preparations and antibiotics were found most frequently among a total of 166 identifiable medicines. The drugs found included 5,998 tablets and capsules, 3,327 ml of liquid preparations, 1,290 g of creams and powders and 369 suppositories and pessaries. These findings are discussed in relation to the drug expenditure of the largest Israel health insurance fund, the serious health hazards which they present, and their possible relevance to the total Israel population. The possibility of a "hoarding-prone" personality is raised.

Analgesics↗

Relation of factor-analyzed symptom dimensions of obsessive-compulsive disorder to personality disorders.

OBJECTIVE: To assess the relation between symptom dimensions of obsessive-compulsive disorder (OCD) and comorbid personality disorders (PDs). METHOD: The scores of 75 OCD outpatients on five previously identified symptom dimensions were entered into multiple regression models as predictors of: 1) the presence of any type of PD; 2) the number of PDs; 3) the presence of any cluster A, B or C PD; and 4) the presence of each individual PD. RESULTS: Twenty-eight patients (37.3%) met criteria for one or more PDs. High scores on the 'Hoarding' dimension were strongly related to the presence of any Axis II diagnosis, and to the number of PDs. Cluster C PDs (especially obsessive-compulsive and avoidant) had the highest partial correlations with 'Hoarding'. These results were independent of OCD symptom severity. CONCLUSION: Previous conflicting findings about the prevalence of certain PDs in OCD might be due in part to differences in the constitution of the particular patient groups studied.

Adolescent↗

Familiality of factor analysis-derived YBOCS dimensions in OCD-affected sibling pairs from the OCD Collaborative Genetics Study.

BACKGROUND: Identification of familial, more homogenous characteristics of obsessive-compulsive disorder (OCD) may help to define relevant subtypes and increase the power of genetic and neurobiological studies of OCD. While factor-analytic studies have found consistent, clinically meaningful OCD symptom dimensions, there have been only limited attempts to evaluate the familiality and potential genetic basis of such dimensions. METHODS: Four hundred eighteen sibling pairs with OCD were evaluated using the Structured Clinical Interview for DSM-IV and the Yale-Brown Obsessive Compulsive Scale (YBOCS) Symptom Checklist and Severity scales. RESULTS: After controlling for sex, age, and age of onset, robust sib-sib intraclass correlations were found for two of the four YBOCS factors: Factor IV (hoarding obsessions and compulsions (p = .001) and Factor I (aggressive, sexual, and religious obsessions, and checking compulsions; p = .002). Smaller, but still significant, familiality was found for Factor III (contamination/cleaning; p = .02) and Factor II (symmetry/ordering/arranging; p = .04). Limiting the sample to female subjects more than doubled the familiality estimates for Factor II (p = .003). Among potentially relevant comorbid conditions for genetic studies, bipolar I/II and major depressive disorder were strongly associated with Factor I (p < .001), whereas ADHD, alcohol dependence, and bulimia were associated with Factor II (p < .01). CONCLUSIONS: Factor-analyzed OCD symptom dimensions in sibling pairs with OCD are familial with some gender-dependence, exhibit relatively specific relationships to comorbid psychiatric disorders and thus may be useful as refined phenotypes for molecular genetic studies of OCD.

Comorbidity↗

Actual and perceived memory deficits in individuals with compulsive hoarding.

Memory problems have been hypothesized to underlie compulsive hoarding behavior [Frost and Hartl, 1996: Behav Res Ther 34:341-350]. This study examined memory performance, memory confidence, and memory beliefs in 22 individuals with severe hoarding symptoms and 24 matched normal control subjects. Participants were administered two measures of learning and memory that required strategic planning and organization for successful performance: the Rey-Osterrieth Complex Figure Test (RCFT) and California Verbal Learning Test (CVLT). Self-reports of memory confidence, perceived consequences of forgetting, importance of remembering, and need to keep possessions in sight also were assessed. In comparison to controls, participants with compulsive hoarding recalled less information on delayed recall of the RCFT and CVLT and used less effective organizational strategies on the RCFT but not the CVLT. Hoarders also reported significantly less confidence in their memory, more catastrophic assessments of the consequences of forgetting, and a stronger desire to keep possessions in sight. Results provide initial evidence of learning and memory impairment and poor memory confidence in subjects with compulsive hoarding.

Adult↗

Hoarding by elderly people.

Although hoarding has been studied in adults, little is known about problems of hoarding by elderly people. This study used a structured telephone interview with elder services providers to investigate hoarding behaviors in relation to functional impairment, cognitive deficits, and physical and psychological conditions in 62 elderly clients. Most elderly hoarders were female, unmarried, and lived alone. Extensive clutter was associated with significant impairment, interfering with basic hygiene, and posing a serious physical threat for many elderly clients. Clients were rarely insightful about their collecting and often resisted change, rendering interventions generally ineffective. Never-married status was associated with more severe hoarding and greater impairment and possibly with worse outcomes of intervention efforts. Health and mental health implications of hoarding by elderly people and implications for treatment are discussed.

Activities of Daily Living↗