Testing the validity and acceptability of the diagnostic criteria for Hoarding Disorder: a DSM-5 survey

2011 ◽  
Vol 41 (12) ◽  
pp. 2475-2484 ◽  
Author(s):  
D. Mataix-Cols ◽  
L.. Fernández de la Cruz ◽  
T. Nakao ◽  
A. Pertusa
Keyword(s):  
Diagnostic Criteria ◽  
Sensitivity And Specificity ◽  
Diagnostic Category ◽  
High Sensitivity ◽  
Obsessive Compulsive ◽  
Hoarding Disorder ◽  
Compulsive Disorder ◽  
Dsm 5 ◽  
The Individual ◽  
Development And Validation

BackgroundThe DSM-5 Obsessive-Compulsive Spectrum Sub-Workgroup is recommending the creation of a new diagnostic category named Hoarding Disorder (HD). The validity and acceptability of the proposed diagnostic criteria have yet to be formally tested.MethodObsessive-compulsive disorder/hoarding experts and random members of the American Psychiatric Association (APA) were shown eight brief clinical vignettes (four cases meeting criteria for HD, three with hoarding behaviour secondary to other mental disorders, and one with subclinical hoarding behaviour) and asked to decide the most appropriate diagnosis in each case. Participants were also asked about the perceived acceptability of the criteria and whether they supported the inclusion of HD in the main manual.ResultsAltogether, 211 experts and 48 APA members completed the survey (30% and 10% response rates, respectively). The sensitivity and specificity of the HD diagnosis and the individual criteria were high (80–90%) across various types of professionals, irrespective of their experience with hoarding cases. About 90% of participants in both samples thought the criteria would be very/somewhat acceptable for professionals and sufferers. Most experts (70%) supported the inclusion of HD in the main manual, whereas only 50% of the APA members did.ConclusionsThe proposed criteria for HD have high sensitivity and specificity. The criteria are also deemed acceptable for professionals and sufferers alike. Training of professionals and the development and validation of semi-structured diagnostic instruments should improve diagnostic accuracy even further. A field trial is now needed to confirm these encouraging findings with real patients in real clinical settings.

Cognitive Behavioral Therapy for Hoarding Disorder in an Older Female

2020 ◽  
Vol 19 (3) ◽  
pp. 205-221
Author(s):  
Kirstin Farquhar ◽  
Roberta Caiazza
Keyword(s):  
Cognitive Behavioral Therapy ◽  
Psychological Intervention ◽  
Behavioral Therapy ◽  
Clinical Excellence ◽  
Evidence Base ◽  
Cognitive Behavioral ◽  
Obsessive Compulsive ◽  
Hoarding Disorder ◽  
Compulsive Disorder ◽  
The Individual

Relationships toward objects can be part of healthy development; however, problems develop when collecting becomes excessive or when the individual has difficulty getting rid of the accumulated items. Hoarding disorder (HD) is defined as an enduring difficulty in discarding possessions as result of a need to save these items, and significant distress linked to disposing of them. Hoarding difficulties are still covered by the clinical guidelines for obsessive-compulsive disorder (OCD) (National Institute for Health and Clinical Excellence), which recommend utilizing psychological therapy at the client’s home. The psychological intervention with the strongest evidence-base is cognitive-behavioral therapy (CBT), but dropout rates are high and difficulties still persist for more than 50% of clients, suggesting that further research is required. Although HD has a higher prevalence in older adults, there is a lack of research into the use of CBT in this population. Preliminary research suggests that adjustments should be made around the difficulties commonly faced by these individuals. This case report outlines the use of CBT to treat “Lucy,” a 67-year-old female with HD complicated by other mental health and physical health difficulties. The case reflects on adaptations that could be made to the existing CBT model.

I Don't Recycle! An Organic Hoarding Disorder

2017 ◽  
Vol 41 (S1) ◽  
pp. S640-S641
Author(s):  
L. Garcia Ayala ◽  
M. Gomez Revuelta ◽  
C. Martin Requena ◽  
E. Saez de Adana Garcia de Acilu ◽  
O. Porta Olivares ◽  
...  
Keyword(s):  
Social Services ◽  
Home Visit ◽  
Treatment Options ◽  
Obsessive Compulsive ◽  
Hoarding Disorder ◽  
Compulsive Disorder ◽  
Dsm 5 ◽  
The Social ◽  
Competing Interest ◽  
Rule Out

IntroductionHoarding often occurs without the presence of obsessive-compulsive disorder (OCD), showing distinguishable neuropsychological and neurobiological correlates and a distinct comorbidity spectrum. Furthermore, it presents itself secondarily to other psychiatric and neurobiological disorders. Therefore hoarding disorder has been included as independent diagnosis in DSM-5.ObjectivesWe aim to expose the possible organic etiology of a hoarding disorder case with atypical presentation.Materials and methodsWe present a case of a 48 years old male patient who was brought to the hospital by the police after being reported for unhealthy conditions in his home. In the home visit paid by the Social Services an excessive hoarding of objects and trash was detected. A possible hoarding disorder was diagnosed in the psychiatric assessment. Among other diagnostic test, a brain CT was conducted, in which a frontal meningioma was identified. After surgical treatment, hoarding symptoms diminished significantly.DiscussionA significant part of the hoarding disorders are attributed to primary psychiatric disorders, resulting in potentially treatable organic pathology going unnoticed.ConclusionIt's important to rule out organic etiology before proceeding to make a definitive hoarding disorder diagnosis, optimizing that way the treatment options.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Hoarding Disorder

2021 ◽  
pp. 63-86
Author(s):  
Blaise Worden ◽  
David F. Tolin
Keyword(s):  
Clinical Characteristics ◽  
Obsessive Compulsive ◽  
Related Disorder ◽  
Hoarding Disorder ◽  
Compulsive Disorder ◽  
Psychological Determinants ◽  
Dsm 5 ◽  
Prevalence Estimates ◽  
Assessment And Treatment ◽  
Chronic Course

This chapter discusses the nature and clinical characteristics of hoarding disorder, a debilitating condition that runs a chronic course without treatment and can lead to significant functional impairment and cost to society. Prevalence estimates for hoarding disorder range from 1.5% to 6% of the general population, and it tends to co-occur with depressive and anxiety disorders. In the DSM-5, hoarding disorder was differentiated from obsessive-compulsive disorder, primarily because of the pronounced differences from OCD in terms of treatment response and phenotype. However, HD remains classified as an obsessive-compulsive and related disorder. This chapter covers the etiology of hoarding disorder across biological and psychological determinants. In addition to the nature of symptoms, contemporary approaches to assessment and treatment are highlighted. The chapter concludes with a discussion of future directions for research.

Structured Interview for Hoarding Disorder (SIHD)

2019 ◽  
Vol 35 (4) ◽  
pp. 512-520
Author(s):  
Caterina Novara ◽  
Paolo Cavedini ◽  
Stella Dorz ◽  
Susanna Pardini ◽  
Claudio Sica
Keyword(s):  
Convergent Validity ◽  
Structured Interview ◽  
Diagnostic Process ◽  
Schizophrenia Spectrum Disorders ◽  
Clinical Environment ◽  
Obsessive Compulsive ◽  
Rater Reliability ◽  
Hoarding Disorder ◽  
Compulsive Disorder ◽  
Schizophrenia Spectrum

Abstract. The Structured Interview for Hoarding Disorder (SIHD) is a semi-structured interview designed to assist clinicians in diagnosing a hoarding disorder (HD). This study aimed to validate the Italian version of the SIHD. For this purpose, its inter-rater reliability has been analyzed as well as its ability to differentiate HD from other disorders often comorbid. The sample was composed of 74 inpatients who had been diagnosed within their clinical environment: 9 with HD, 11 with obsessive-compulsive disorder (OCD) and HD, 22 with OCD, 19 with major depressive disorder (MDD), and 13 with schizophrenia spectrum disorders (SSD). The results obtained indicated “substantial” or “perfect” inter-rater reliability for all the core HD criteria, HD diagnosis, and specifiers. The SIHD differentiated between subjects suffering from and not suffering from a HD. Finally, the results indicated “good” convergent validity and high scores were shown in terms of both sensitivity and specificity for HD diagnosis. Altogether, the SIHD represents a useful instrument for evaluating the presence of HD and is a helpful tool for the clinician during the diagnostic process.

scholarly journals Stopping a Response When You Really Care about the Action: Considerations from a Clinical Perspective

2021 ◽  
Vol 11 (8) ◽  
pp. 979
Author(s):  
Sharon Morein-Zamir ◽  
Gideon Anholt
Keyword(s):  
Response Inhibition ◽  
Action Control ◽  
Common Denominator ◽  
Obsessive Compulsive ◽  
Apparent Paradox ◽  
Compulsive Disorder ◽  
Reward Seeking ◽  
Threat Avoidance ◽  
The Individual ◽  
Action Tendencies

Response inhibition, whether reactive or proactive, is mostly investigated in a narrow cognitive framework. We argue that it be viewed within a broader frame than the action being inhibited, i.e., in the context of emotion and motivation of the individual at large. This is particularly important in the clinical domain, where the motivational strength of an action can be driven by threat avoidance or reward seeking. The cognitive response inhibition literature has focused on stopping reactively with responses in anticipation of clearly delineated external signals, or proactively in limited contexts, largely independent of clinical phenomena. Moreover, the focus has often been on stopping efficiency and its correlates rather than on inhibition failures. Currently, the cognitive and clinical perspectives are incommensurable. A broader context may explain the apparent paradox where individuals with disorders characterised by maladaptive action control have difficulty inhibiting their actions only in specific circumstances. Using Obsessive Compulsive Disorder as a case study, clinical theorising has focused largely on compulsions as failures of inhibition in relation to specific internal or external triggers. We propose that the concept of action tendencies may constitute a useful common denominator bridging research into motor, emotional, motivational, and contextual aspects of action control failure. The success of action control may depend on the interaction between the strength of action tendencies, the ability to withhold urges, and contextual factors.

scholarly journals Schizophrenia-spectrum psychopathology in obsessive–compulsive disorder: an empirical study

2019 ◽  
Vol 270 (8) ◽  
pp. 993-1002 ◽  
Author(s):  
Andreas Rosén Rasmussen ◽  
Julie Nordgaard ◽  
Josef Parnas
Keyword(s):  
Diagnostic Criteria ◽  
Obsessive Compulsive Disorder ◽  
Psychotic Symptoms ◽  
Main Diagnosis ◽  
Schizophrenia Spectrum Disorders ◽  
Obsessive Compulsive ◽  
Main Research ◽  
Compulsive Disorder ◽  
Diagnostic Potential ◽  
Schizophrenia Spectrum

Abstract The differential diagnosis of obsessive–compulsive disorder (OCD) and schizophrenia-spectrum disorders can be difficult. In the current diagnostic criteria, basic concepts such as obsession and delusion overlap. This study examined lifetime schizophrenia-spectrum psychopathology, including subtle schizotypal symptomatology and subjective anomalies such as self-disorders, in a sample diagnosed with OCD in a specialized setting. The study also examined the differential diagnostic potential of the classic psychopathological notions of true obsession (‘with resistance’) and pseudo-obsession. The study involved 42 outpatients diagnosed with OCD at two clinics specialized in the treatment of OCD. The patients underwent semi-structured, narrative interviews assessing a comprehensive battery of psychopathological instruments. The final lifetime research-diagnosis was based on a consensus between a senior clinical psychiatrist and an experienced research clinician. The study found that 29% of the patients fulfilled criteria of schizophrenia or another non-affective psychosis as main, lifetime DSM-5 research-diagnosis. Another 33% received a research-diagnosis of schizotypal personality disorder, 10% a research-diagnosis of major depression and 29% a main research-diagnosis of OCD. Self-disorders aggregated in the schizophrenia-spectrum groups. True obsessions had a specificity of 93% and a sensitivity of 58% for a main diagnosis of OCD. In conclusion, a high proportion of clinically diagnosed OCD patients fulfilled diagnostic criteria of a schizophrenia-spectrum disorder. The conspicuous obsessive–compulsive symptomatology may have resulted in a disregard of psychotic symptoms and other psychopathology. Furthermore, the differentiation of obsessions from related psychopathological phenomena is insufficient and a conceptual and empirical effort in this domain is required in the future.

Hoarding Disorder

2017 ◽  
Author(s):  
Christine Lochner ◽  
Dan Stein ◽  
Eileen Thomas
Keyword(s):  
Key Words ◽  
Obsessive Compulsive Disorder ◽  
Obsessive Compulsive ◽  
Related Disorder ◽  
Statistical Manual ◽  
Hoarding Disorder ◽  
Compulsive Disorder ◽  
Diagnostic And Statistical Manual

Hoarding disorder is characterized by an obsessive need to acquire, collect, or keep possessions and difficulty in organizing and discarding, resulting in accumulation of clutter, which elicits great concern from family and friends. Functioning is usually impaired in a variety of domains. Obsessive-compulsive disorder is the disorder most closely associated with hoarding. Overvalued ideation regarding the value or usefulness of possessions may make it impossible for individuals to discard items. This review contains 1 table, and 22 references. Key words: clutter, diagnostic and statistical manual, etiology, hoarding, obsessive-compulsive and related disorder

OCD in Women: Diagnosis and Magnitude

CNS Spectrums ◽  
2004 ◽  
Vol 9 (9) ◽  
pp. 14-16
Author(s):  
Teresa A. Pigott
Keyword(s):  
Collaborative Group ◽  
Obsessive Compulsive ◽  
Statistical Manual ◽  
Symptom Dimensions ◽  
Compulsive Disorder ◽  
Diagnostic And Statistical Manual ◽  
Lifetime Prevalence Rate ◽  
Prevalence Estimates ◽  
Area Survey ◽  
The Individual

Key Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria for obsessive-compulsive disorder (OCD) include the presence of either obsessions or compulsions, some recognition by the individual that their symptoms are excessive or irrational (except in children), duration of at least 1 hour/day, and association with marked distress or functional impairment. OCD patients report that somatic, religious, and sexual obsessions as well as those concerning contamination, aggression, symmetry, and hoarding are most common. The most frequent compulsions reported in OCD patients involve checking, cleaning, counting, repeating, and hoarding behaviors. Factor analyses of the Yale-Brown Obsessive Compulsive Scale (Y-BOCS) symptom checklist have also identified five primary symptom dimensions: aggression/checking; contamination/cleaning; symmetry/repeating, counting, or ordering rituals; hoarding; and a sexual/religious symptom dimension.Results from a large, 2-year prospective study suggest that symptoms of adult OCD are much more stable than previously thought, with any changes more likely to occur within, rather than between the symptom dimensions. Prevalence estimates based on the Epidemiologic Catchment Area survey and the Cross-National OCD Collaborative Group study indicate a worldwide lifetime prevalence rate for OCD of 2% to 3%. Females have a slightly higher risk (1.5 times) for OCD (Slide I). OCD onset is relatively early, generally during adolescence or young adulthood. The clinical course of OCD is generally chronic and complicated by comorbidities.

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