Vallejo-Nágera (1926–1990) and the concept of ‘soteric neurosis’: a forgotten sketch of hoarding disorder in the obsessive-compulsive spectrum literature

Abstract

Juan Antonio Vallejo-Nágera, psychiatrist, painter and writer, wrote a widely adopted textbook of psychiatry in Spanish- and Portuguese-speaking countries, particularly during the 1970s, the famous Introducción a la psiquiatría. There, he advanced the concept of soteric neurosis, a condition regarded as a 'mirror image' of phobias and similar to the diagnostic entity described in DSM-5 under the heading of hoarding disorder. Indeed, much earlier than the recent nosological discussions on hoarding, Vallejo-Nágera already reported soteric neurosis to be distinct from obsessive-compulsive disorder and to be associated with excessive attachment to objects and positive affect (pleasure), leading to accumulation, decreased treatment seeking, increasing interference in daily activities and blurred boundaries with normality. Vallejo-Nágera also made several predictions, including the propensity soteric neurosis patients may have towards the development of separation anxiety, obesity and other 'masked' symptoms. In the light of his original and insightful contributions to the concept of hoarding disorder, it would be interesting to assess his hypotheses in future studies.