Co-occurring Obsessive-Compulsive Disorder and Hoarding Disorder: A Review of the Current Literature

Area of Science:

• Psychiatry
• Clinical Psychology
• Neuroscience

Background:

• Obsessive-compulsive disorder (OCD) co-occurs in approximately 20% of individuals with hoarding disorder (HD).
• Understanding the similarities and differences between HD and OCD is crucial for accurate diagnosis and effective treatment planning.

Approach:

• This article explores the theoretical conceptualization of co-occurring HD and OCD (HD+OCD).
• It examines overlapping etiological factors, phenomenological aspects, and distinct features like belief patterns and ego-syntonicity/dystonicity.

Key Points:

• The HD+OCD profile is associated with increased nonhoarding OCD symptoms, anxiety, depression, and tic disorders.
• Hoarding symptoms may be less responsive to standard exposure and response prevention (ERP) therapy.
• Accurate assessment of hoarding in OCD patients, especially children, is challenging.

Conclusions:

• Co-occurring HD and OCD presents a complex clinical picture that may be more treatment-refractory.
• Differential diagnosis is essential, considering unique belief patterns and symptom presentation.
• Current treatment protocols for HD+OCD are limited, necessitating further research into tailored cognitive-behavioral therapy (CBT) approaches.