Group cognitive-behavioral therapy for hoarding disorder: An open trial

Gilliam, Christina M.; Norberg, Melissa M.; Villavicencio, Anna; Morrison, Samantha; Hannan, Scott; Tolin, David F.

doi:10.1016/j.brat.2011.08.008

Cited by 73 publications

(84 citation statements)

References 34 publications

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“…Women may have few clutter symptoms early in life, but this does not seem to impact clutter levels in older adulthood. These results are interesting in light of gender disparity in treatment-seeking samples of adults with compulsive hoarding, with more women than men volunteering to participate in hoarding studies (Ayers & Dozier, 2014;Gilliam et al, 2011;Muroff et al, 2009;Steketee et al, 2010), suggesting that gender may factor into symptom presentation.…”

Section: Discussionmentioning

confidence: 92%

Age of onset and progression of hoarding symptoms in older adults with hoarding disorder

Dozier

Porter

Ayers

2015

Aging & Mental Health

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Objectives-We investigated (1) age of onset of hoarding disorder (HD) symptoms and diagnosis, (2) late-onset HD, (3) progression of HD symptoms, and (4) association between demographics and hoarding progression.Method-Eighty-two older adults with HD provided retrospective ratings of their hoarding symptoms for each decade of life. Age of onset of symptoms (saving, difficulty discarding, and clutter) was operationalized as the first decade in which the participant reported at least minor symptom severity, and age of onset for possible HD diagnosis was operationalized as the first decade in which the participant reported all three symptoms. We used mixed effects modeling to examine the progression of HD symptoms.Results-The median age of onset for symptoms was between 10 and 20 years, and the median age of onset for possible HD diagnosis was between 20 and 30 years. Twenty-three percent of participants reported onset of possible HD diagnosis after the age of 40. All HD symptoms increased in severity over time. Men reported higher initial clutter and a slower increase in hoarding severity for all symptoms. Increased education was associated with slower increase in saving. Having at least one parent with hoarding tendencies was associated with higher initial hoarding symptoms.Conclusion-Generally, symptoms of HD begin relatively early and worsen across the lifespan. However, approximately one fourth of older adults with HD reported a possible onset after the age of 40.

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Section: Discussionmentioning

confidence: 92%

Age of onset and progression of hoarding symptoms in older adults with hoarding disorder

Dozier

Porter

Ayers

2015

Aging & Mental Health

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“…In published CBT trials, improvement in compulsive hoarding symptoms, measured by decline in mean SI-R score, has ranged from 10–30% for group CBT (Steketee et al 2000, Muroff et al 2009, Muroff et al 2010, Gilliam et al 2011, Muroff et al 2012) to 27–28% for individual CBT (Tolin et al 2007, Steketee et al 2010). However, in the present study, treatment with venlafaxine extended-release resulted in a 32% mean improvement on the SI-R and 36% on the UHSS, while in the previous paroxetine study, mean symptom improvement was 31% for completers and 24% for the entire sample in an intent to treat analysis (Saxena et al 2007).…”

Section: Discussionmentioning

confidence: 99%

Venlafaxine extended-release treatment of hoarding disorder

Saxena

Sumner

2014

International Clinical Psychopharmacology

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Objectives Hoarding Disorder, classified as a separate disorder in DSM-5, is a common, chronic, and potentially disabling syndrome that can be difficult to treat. Only one prior study prospectively measured response to pharmacotherapy in compulsive hoarders, finding that hoarders responded as well to paroxetine as did non-hoarding OCD patients. However, paroxetine was not tolerated well in that study, and overall response was moderate. Therefore, we conducted an open-label trial of venlafaxine extended-release for Hoarding Disorder. Methods 24 patients meeting DSM-5 criteria for Hoarding Disorder were treated with venlafaxine extended-release for 12 weeks. All patients were free of psychotropic medications for at least 6 weeks prior to the study. No other psychotropic medications, cognitive-behavioral therapy, organizers, or cleaning crews were permitted during the study. To measure hoarding severity, the Saving Inventory-Revised (SI-R) and the UCLA Hoarding Severity Scale (UHSS) were administered before and after treatment. Results 23 of the 24 patients completed treatment. Hoarding symptoms improved significantly, with a mean 36% decrease in UHSS scores and a mean 32% decrease in SI-R scores. Sixteen of the 23 completers (70%) were classified as responders to venlafaxine extended-release. Conclusions These results suggest that venlafaxine extended-release may be effective for treatment of Hoarding Disorder.

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“…Other (non-randomized controlled trial) studies have also suggested that multimodal approaches may be beneficial [59][60][61]. These include CBT either in individual or group format [59, 62•] as well as office and in-home visits emphasizing motivational interviewing, psychoeducation, decisionmaking training, exposure to situations of discarding items, cognitive restructuring, and response prevention (i.e., restricted acquisition of items) [56][57][58]63].…”

Section: Hdmentioning

confidence: 99%

Treatment of Obsessive-Compulsive and Related Disorders

Löchner

Stein²

2014

Curr Treat Options Psych

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Pharmacotherapy and cognitive-behavioural therapy (CBT) have been studied in many of the obsessive-compulsive and related disorders (OCRDs). Serotonin reuptake inhibitors (SRIs) and cognitive-behavioural therapies (CBT) are first-line considerations in many, but not all, of these conditions. There are fewer data available on the combination of these treatment modalities in OCRDs. In obsessive-compulsive disorder (OCD), the SRIs and CBT -which include exposure and response prevention (ERP) -are wellestablished safe and efficacious first-line treatments in adult and paediatric populations. While various pharmacotherapy augmentation strategies have been studied, the most evidence-based approach to date is augmentation with antipsychotic agents. There is also evidence of the value of CBT in the management of treatment-refractory patients. A number of SRIs, such as clomipramine and fluoxetine, have shown efficacy in randomized controlled trials of the pharmacotherapy of body dysmorphic disorder (BDD). There are relatively few data on pharmacotherapy augmentation approaches in BDD. CBT has also been found efficacious in a number of psychotherapy trials of BDD. Less is known about the optimal treatment of the other OCRDs, i.e., hoarding disorder (HD), trichotillomania (hair-pulling disorder, or HPD), and excoriation (skin-picking) disorder (SPD). While patients with HD may have been included in RCTs on OCD, no data from randomized controlled trials of pharmacotherapy specifically for HD have been reported. There is some support for the value of CBT in HD. In HPD, controlled trials of olanzapine, N-acetyl cysteine (NAC), and clomipramine (vs. desipramine) have provided evidence of efficacy. There also is evidence supporting the efficacy of behaviour therapy in reducing hair-pulling. Results from randomized controlled trials of SRIs in SPD have been mixed, with some agents such as fluoxetine and citalopram demonstrating improvement on certain measures of picking behaviour. Behaviour therapy also appears to be useful for SPD.

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Group cognitive-behavioral therapy for hoarding disorder: An open trial

Cited by 73 publications

References 34 publications

Age of onset and progression of hoarding symptoms in older adults with hoarding disorder

Age of onset and progression of hoarding symptoms in older adults with hoarding disorder

Venlafaxine extended-release treatment of hoarding disorder

Treatment of Obsessive-Compulsive and Related Disorders

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