Hoarding OCD behavior

Topics: Compulsive hoarding, Selective serotonin reuptake inhibitor, Cognitive behavioral therapy Pages: 9 (6491 words) Published: October 15, 2014
Review

Álvaro Frías-Ibáñez1
Carol Palma-Sevillano1
Francisco Barón-Fernández1
Inma Bernáldez-Fernández2
Elena Aluco-Sánchez2

Nosological status of compulsive
hoarding: obsessive-compulsive disorder
subtype or independent clinical entity
1

FPCEE Blanquerna. Universitat Ramon-Llull, Barcelona

2

Servicio de Psiquiatría. Hospital de Mataró, Barcelona

ABSTRACT. This theoretical study reviews the main research and findings on the nosological status of compulsive hoarding. Specifically, it describes available empirical evidence in order to determine their independence or inclusion within the obsessive-compulsive disorder (OCD), a mental

disorder in which it has traditionally been included as one
more subtype or dimension. Regarding this issue, the results found in the scientific literature show that persons with
compulsive hoarding have distinct characteristics in different external criteria like sociodemographic variables, premorbid personality, degree of insight, neuroanatomical and genetic factors, neuropsychological profile, clinical course, levels of dysfunctionality and finally, treatment outcome.

These conclusions are discussed and the proposal for the
creation of a new clinical entity called “hoarding disorder” is evaluated.
Keywords: Compulsive hoarding, Hoarding disorder, Obsessive-compulsive disorder, Nosological status, Theoretical study

Actas Esp Psiquiatr 2014;42(3):116-24

Estatus nosológico de la acumulación compulsiva:
¿subtipo de trastorno obsesivo-compulsivo o
entidad clínica independiente?

RESUMEN. En el presente estudio teórico se revisan los
principales hallazgos e investigaciones respecto al estatus
nosológico de la acumulación compulsiva. En concreto, se
exponen las evidencias empíricas disponibles para poder determinar su independencia o no del trastorno obsesivo-compulsivo (TOC), patología mental donde tradicionalmente ha sido incluida como un subtipo o dimensión más de la misma. En relación a esta cuestión, los resultados recogidos en la literatura científica sostienen que las personas con acumulación compulsiva, a diferencias de “otros” sujetos con TOC, presentan características distintivas en diversos criterios externos, a saber: variables sociodemográficas, personalidad premórbida, grado de insight, factores genéticos y neuroanatómicos, correlatos neuropsicológicos, curso y nivel de disfuncionalidad y, por último, respuesta al tratamiento.

Dichas conclusiones son discutidas valorando la propuesta
de creación de una nueva entidad clínica denominada “trastorno por acumulación”. Palabras clave: Acumulación compulsiva, Trastorno por acumulación, Trastorno obsesivocompulsivo, Estatus nosológico, Estudio teórico

Correspondence:
Álvaro Frías Ibáñez
Servicio de Psiquiatría. Hospital de Mataró
Crta Cirera s/n.
CP: 08304 Mataró (Barcelona), Spain
E-mail: afrias@csdm.cat

116

Actas Esp Psiquiatr 2014;42(3):116-24

Álvaro Frías-Ibáñez, et al.

Nosological status of compulsive hoarding: obsessive-compulsive disorder subtype or independent clinical entity

Introduction
From an evolutionary point of view, the tendency for
the human to accumulate different types of objects has
been a philogenetically adaptive behavior, allowing for
survival of the species in times of crisis or need.1 Therefore, this activity is inherent to the ontogenetic development of
the persons so that most children show some type of
hoarding behavior during this initial phase of cognitive
development.2
Within the psychopathological setting, little clinical
attention has been given to compulsive hoarding, and it has
only been included in the DSM-IV-TR3 as one of the
diagnostic criteria for obsessive-compulsive personality
disorder (OCPD). In the clinical practice, it is a secondary or accessory symptom identified in other mental conditions
such as residual schizophrenia, major depression, dementia,
pervasive developmental disorders, mental retardation,...
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