Obsessive-compulsive disorder with hoarding behavior: unravelling key differences.

Area of Science:

• Psychiatry
• Clinical Psychology
• Neuroscience

Background:

• Hoarding disorder (HD) is increasingly recognized as a distinct condition, separate from obsessive-compulsive disorder (OCD).
• Despite its impact, HD remains underexplored, particularly its relationship with OCD.
• Understanding these differences is crucial for effective diagnosis and treatment.

Purpose of the Study:

• To investigate the clinical differences between individuals with OCD and hoarding disorder (OCD+pHD) and those with OCD without hoarding disorder (OCD-pHD).
• To identify specific demographic, clinical, and comorbidity patterns associated with hoarding disorder in an OCD population.

Main Methods:

• A cohort study of 1247 individuals with OCD-pHD and 663 individuals with OCD+pHD was conducted.
• Sociodemographic data, psychiatric comorbidities, and OCD severity (using Florida Obsessive-Compulsive Inventory and Y-BOCS) were assessed.
• Statistical significance was determined using p ≤ 0.0007, adjusted for multiple comparisons.

Main Results:

• The OCD+pHD group exhibited lower educational attainment, higher likelihood of living alone or in supervised settings, and lower marriage rates.
• More severe OCD symptoms, poorer insight, and increased frequency of most obsessions/compulsions were noted in the OCD+pHD group.
• Higher rates of major depressive disorder, PTSD, bipolar disorder, schizophrenia, body dysmorphic disorder, trichotillomania, and ADHD symptoms were found in the OCD+pHD group.

Conclusions:

• Significant clinical distinctions exist between OCD with and without hoarding disorder.
• These findings underscore the need for further research to refine diagnostic criteria and improve support for individuals with hoarding disorder.
• Enhanced understanding can lead to better conceptualization, awareness, and targeted interventions for hoarding disorder within the OCD spectrum.