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Comorbidity in compulsive hoarding: a case report

Alicia Kaplan1, Eric Hollander

  • 1Department of Psychiatry, Mount Sinai School of Medicine, New York City, New York 10029-6574, USA.

CNS Spectrums
|March 6, 2004
PubMed

Insights

Compulsive hoarding, often difficult to treat, showed improvement with a combination of medication and behavioral therapy in a patient with ADHD and schizotypal personality disorder. Stimulant augmentation may benefit hoarding symptoms like procrastination.

Area of Science:

  • Psychiatry
  • Neuroscience
  • Behavioral Science

Background:

  • Compulsive hoarding is a complex condition often comorbid with other psychiatric disorders.
  • Treatment-resistant hoarding presents significant challenges for patients and clinicians.
  • Attention-deficit/hyperactivity disorder (ADHD) and schizotypal personality disorder can exacerbate hoarding severity.

Observation:

  • A 56-year-old male with compulsive hoarding, ADHD, and schizotypal personality disorder was treated with fluvoxamine, amphetamine salts, and risperidone.
  • Behavioral therapy was integrated into the patient's treatment regimen.
  • The patient exhibited significant improvements in hoarding behaviors, motivation, and socialization.

Findings:

  • The multimodal treatment approach effectively reduced hoarding symptoms.
  • Amphetamine salts, as an augmentation strategy, appeared to alleviate procrastination.
  • Improvements in motivation and increased socialization were noted.

Implications:

  • Hoarding disorder may represent a distinct subtype of obsessive-compulsive disorder with unique neurobiological underpinnings.
  • Stimulant augmentation could be a valuable therapeutic strategy for hoarding, particularly in patients with comorbid ADHD.
  • Further research into the neuroanatomy and treatment of hoarding subtypes is warranted.

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