Pharmacotherapy for Hoarding Disorder: How did the Picture Change since its Excision from OCD?

Piacentino, Daria; Pasquini, Massimo; Cappelletti, Simone; Chetoni, Chiara; Sani, Gabriele; Kotzalidis, Georgios D.

doi:10.2174/1570159x17666190124153048

Cited by 22 publications

(8 citation statements)

References 81 publications

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“…Consideration of comorbid hoarding in ADHD should contribute to behavioral and pharmacotherapy treatment choices. For example, preliminary open-label data suggest atomoxetine may be effective for HD symptoms ( Grassi et al, 2016 ), as do some SSRIs ( Piacentino et al, 2019 ). However, in part due to HD being recognised only recently randomized control trials are still lacking.…”

Section: Discussionmentioning

confidence: 99%

Elevated levels of hoarding in ADHD: A special link with inattention

Morein‐Zamir

Kasese

Chamberlain

et al. 2022

Journal of Psychiatric Research

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Hoarding Disorder (HD) is under recognised and under-treated. Though HD develops by early adulthood, patients present only later in life, resulting in research based largely on samples of predominantly older females. Whilst formerly associated with Obsessive-Compulsive Disorder (OCD), it is now recognised that individuals with HD often have inattention symptoms reminiscent of Attention Deficit/Hyperactivity Disorder (ADHD). Here, we investigated HD in adults with ADHD. Patients in an ADHD clinic (n=88) reported on ADHD, HD and OCD-related symptoms, and compared with age, gender and education matched controls (n=90). Findings were assessed independently in an online UK sample to verify replication using a dimensional approach (n=220). Clinically significant hoarding symptoms were found in ~20% versus 2% of ADHD and control groups, respectively, with those with hoarding being on average in their thirties and with approximately half being male. Greater hoarding severity was noted even in the remaining patients compared with controls (d=0.89). Inattention was the only significant statistical predictor of hoarding severity in patients. Similarly, inattention, alongside depression and anxiety were the greatest predictors of hoarding in the independent sample where 3.2% identified as having clinically significant hoarding. Patients with ADHD had a high frequency of hoarding symptoms, which were specifically linked to inattention. HD should be routinely assessed in individuals with ADHD, as they do not typically disclose associated difficulties, despite these potentially leading to impaired everyday fimctioning. Research in HD should also investigate adults with ADHD, who are younger and with a greater prevalence of males than typical HD samples.

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Section: Discussionmentioning

confidence: 99%

Elevated levels of hoarding in ADHD: A special link with inattention

Morein‐Zamir

Kasese

Chamberlain

et al. 2022

Journal of Psychiatric Research

View full text Add to dashboard Cite

show abstract

“…Consideration of comorbid hoarding in ADHD patients should contribute to behavioural and potentially to pharmacotherapy treatment choices. For example, preliminary open-label data suggest atomoxetine may be effective for HD symptoms (Grassi et al, 2016), as do some SSRIs (Piacentino et al, 2019). However, in part due to HD being recognised only recently as a distinct condition, randomized control pharmacological trials are still lacking.…”

Section: Discussionmentioning

confidence: 99%

Elevated levels of hoarding in ADHD: a special link with inattention

Morein‐Zamir

Kasese

Chamberlain

et al. 2020

Preprint

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Background: Hoarding Disorder (HD) is under recognised and under-treated. Though HD develops by early adulthood, patients present only later in life, resulting in research based largely on samples of predominantly older females. Previously linked to Obsessive Compulsive Disorder (OCD), individuals with HD often have high inattention levels reminiscent of Attention Deficit/ Hyperactivity Disorder (ADHD). Here, we investigated HD in adults with ADHD. Methods: Patients in an ADHD clinic (n=88) reported on ADHD-, and OCD-related symptoms. Patients were compared to age, gender and education matched controls (n=90). Findings were compared to those in an independent online UK sample (n=220). Results: Clinically significant hoarding symptoms were found in ∼20% versus 2% of ADHD and control groups, respectively, with hoarders being on average in their thirties and balanced gender-wise. Greater hoarding severity was noted even in non-hoarding ADHD patients compared with controls (d=0.89). Inattention was the only significant statistical predictor of hoarding severity in ADHD patients. Similarly, inattention, alongside depression and anxiety were the greatest predictors of hoarding in the independent sample where 3.2% were identified as hoarders. Conclusion: Adult ADHD patients had a high frequency of hoarding symptoms, which were specifically linked to inattention. HD should be routinely assessed in ADHD patients, as they do not typically disclose associated difficulties, despite these potentially leading to impaired everyday functioning. Research in HD should investigate ADHD patients, who are younger and with a greater prevalence of males than typical HD samples.

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“…Since atomoxetine appeared to be effective in diminishing HD symptoms, therefore, controlled clinical trials need to be carried out with atomoxetine as a promising candidate for the management of HD. Several case studies highlight the difficulties involved in managing late-life compulsive hoarding inclusive of delicate handling of elderly patients, co-existent psychiatric illnesses, the importance of caution, and non-adherence to treatment 59 .…”

Section: Pharmacotherapymentioning

confidence: 99%

“…Lack of motivation to change hoarding behavior has been identified as a big hurdle in managing the patients suffering from HD. Although most individuals who present for treatment exhibit some recognition that they have a hoarding problem seem to be reluctant to make the necessary changes in their behavior 59,68 . The therapist should not take a confrontational role.…”

Section: Non-drug Treatment: Cognitive-behavioral Treatment Of Compul...mentioning

confidence: 99%

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2022

IJPSR

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Hoarding behavior is a normal phenomenon commonly observed in all corners of the world to prevent future scarcity of resources and overcome challenges of survival. Hoarding signs typically develop in childhood or early adolescence, which may become a serious disorder in the late phase of life. At present, hoarding disorder has been covered under the chapter of "Obsessive-Compulsive and Related Disorders" along with obsessive-compulsive disorder, body dysmorphic disorder, trichotillomania (hair-pulling disorder), and excoriation (skinpicking) disorder as per DSM-5. Hoarding disorder (HD) is defined as a persistent difficulty discarding possessions, resulting in an accumulation of belongings, causing severe clutter and the congestion of living areas. HD appears to be a chronic problem that presents a burden on family and society. Pharmacotherapy of this disorder exhibits a gloomy picture since no approved allopathic medicines are available for its management. The best clinically proven way to manage hoarding disorder is with cognitive behavioral therapy, which motivates the patient specifically in addressing the key characteristics of this disorder. Recent lines of evidence suggest that hoarding disorder is therapeutical, neuro-biologically, socially, and genetically a personality disorder distinct from anxiety as well as obsessivecompulsive disorder. This review article depicts with the help of a diagram how HD is different from normal collecting/hoarding behavior. The hoarding disorder may be looked upon as an extension of the normal collecting (hoarding) phenomenon, which not only becomes a personality deformity but presents a dangerous clinical picture in elderly individuals complicated by the presence of other psychiatric co-morbidities. INTRODUCTION:Preamble: Hoarding behavior is a normal phenomenon commonly observed in all corners of the world to prevent future scarcity of resources and overcome survival challenges. Hoarding symptoms typically develop in childhood or early adolescence,

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Pharmacotherapy for Hoarding Disorder: How did the Picture Change since its Excision from OCD?

Cited by 22 publications

References 81 publications

Elevated levels of hoarding in ADHD: A special link with inattention

Elevated levels of hoarding in ADHD: A special link with inattention

Elevated levels of hoarding in ADHD: a special link with inattention

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