Prevalence and Correlates of Difficulty Discarding

Abstract

Objectives This study presents nationally representative data on the prevalence and correlates of difficulty discarding, a behavior described in many psychiatric disorders, including a new diagnosis in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, called hoarding disorder. Methods Data were derived from the National Epidemiologic Survey on Alcohol and Related Conditions, a national sample of the U.S. population (n= 43,093). Difficulty discarding worn-out/worthless items (assessed by a single item) and diagnoses of psychiatric disorders were based on the Alcohol Use Disorder and Associated Disabilities Interview Schedule. Results The prevalence of difficulty discarding worn-out/worthless items in the general population was 20.6%. Difficulty discarding strongly correlated with Axis I and Axis II disorders, level of impairment and use of mental health services. Conclusions Difficulty discarding worn-out/worthless items is a common behavior that can be associated with various forms of psychopathology. When reported in a clinical setting, it may signal that careful assessment is needed to clarify diagnosis and inform treatment strategies.

The National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) Waves 1 and 2: review and summary of findings

“…Studies examined comorbidity associated with many specific symptoms: anhedonia [150], social isolation [151], panic attacks [152], hoarding [153], hazardous alcohol use [154], impulsivity [155], lack of remorse [156], shoplifting [157], firesetting [158], cruelty to animals [159], violent behaviors [160], nicotine withdrawal [161], and other symptoms or behaviors [162-166]. Participants with suicidality (ideation/behavior) had greater comorbidity than others [166-185], as did smokers [69,161,170,179,186-200] and those who used alcohol/drugs to ameliorate mood/or feel better (self-medication) [201-209].…”

Identificação e cuidados no transtorno de acumulação

“…14 AD affects both genders and is associated with substantial adversities, but, some research suggests a higher incidence in men. 12,15 It can be observed in different cultures and with varying age for onset of signs and symptoms. The estimated prevalence is 2% to 6% in the general population, presenting greater severity in the elderly.…”

“…18 Research has concluded that the accumulation behavior is a diagnosis whose course may occur concomitantly with other mental disorders, such as Personality Disorder, Generalized Anxiety Disorder, Depression, Dementia, Schizophrenia, OCD, Bipolar Mood Disorder, Social Phobia, among others. 12,15 Until inclusion in DSM-5, accumulation symptoms were often classified as a spectrum of OCD. The expressed cognitions of many individuals who accumulate could be understood as obsessions characterized by a fear of losing things and compulsions to acquire and store objects.…”

“…However, finally, with inclusion in DSM-5, it was recognized as a clinical syndrome per se. 15,17 In the manual, pathology is presented in the chapter on obsessive-compulsive disorder and related disorders, with the categories of overacquisition and varied insight. 18 The three main commonly identified symptoms, are difficulty in discarding, disorder, and overacting.…”

The Relationship between Hoarding Symptoms, Intolerance of Uncertainty, and Error-Related Negativity

“…The primary symptoms of hoarding disorder (HD) -acquiring, clutter, and difficulty discarding -are strongly associated with severe psychiatric and psychosocial dysfunction (Rodriguez et al 2013;Samuels et al 2008;Tolin et al 2008), and are surprisingly prevalent -estimated between 2.3 % -6 % of the population (Bulli et al 2013;Iervolino et al 2009;Mueller et al 2009;Timpano et al 2011). Cognitive behaviour therapy (CBT) for hoarding is empirically successful but resource-intensive and inconsistent in efficacy , and evidence for pharmacotherapy is nascent (Saxena 2011;Saxena and Sumner 2014).…”