title: Compulsive hoarding: OCD symptom, distinct clinical syndrome, or both?
abstract: OBJECTIVE
  Compulsive hoarding is a debilitating problem that is often associated with obsessive-compulsive disorder (OCD) and obsessive-compulsive personality disorder. However, the precise nosology of compulsive hoarding has yet to be determined.
  
  
  METHODS
  Participants were 25 patients with severe compulsive hoarding with OCD and 27 patients with severe compulsive hoarding without OCD. Both groups were carefully characterized and compared on the following sociodemographic and clinical variables: precise phenomenology of hoarding behavior, severity of other OCD symptoms, axis I and axis II psychopathology, and adaptive functioning. For comparison purposes, the following individuals were also recruited: 71 patients with OCD without hoarding, 19 patients with anxiety disorder, and 21 community participants.
  
  
  RESULTS
  Overall, the phenomenology of hoarding behavior was similar in the two hoarding groups. The majority of participants in both groups reported hoarding common items as a result of their emotional and/or intrinsic value. However, approximately one-fourth of participants in the compulsive hoarding with OCD group showed a different psychopathological profile, which was characterized by the hoarding of bizarre items and the presence of other obsessions and compulsions related to their hoarding, such as fear of catastrophic consequences, the need to perform checking rituals, and the need to perform mental compulsions before discarding any item. These patients had a more severe and disabling form of the disorder. The strong relationship between compulsive hoarding and obsessive-compulsive personality disorder was explained entirely by the overlapping item content.
  
  
  CONCLUSIONS
  In most individuals, compulsive hoarding appears to be a syndrome separate from OCD, which is associated with substantial levels of disability and social isolation. However, in other individuals, compulsive hoarding may be considered a symptom of OCD and has unique clinical features. These findings have implications for the classification of OCD and compulsive hoarding in the next edition of DSM.
authors.affiliation: Division of Psychological Medicine, King's College London, Institute of Psychiatry, PO 69, De Crespigny Park Rd., London SE58AF, United Kingdom. alberto.pertusa@iop.kcl.ac.uk
authors.forename: Alberto
authors.initials: A
authors.lastname: Pertusa
authors.forename: Miguel A
authors.initials: MA
authors.lastname: Fullana
authors.forename: Satwant
authors.initials: S
authors.lastname: Singh
authors.forename: Pino
authors.initials: P
authors.lastname: Alonso
authors.forename: José M
authors.initials: JM
authors.lastname: Menchón
authors.forename: David
authors.initials: D
authors.lastname: Mataix-Cols
mesh_terms: D000203:Activities of Daily Living / Q000523:psychology; D000328:Adult; D017668:Age of Onset; D000368:Aged; D001008:Anxiety Disorders / Q000175:diagnosis / Q000523:psychology; D015897:Comorbidity; D003192:Compulsive Behavior / Q000145:classification / Q000175:diagnosis* / Q000523:psychology; D003937:Diagnosis, Differential; D039721:Diagnostic and Statistical Manual of Mental Disorders; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D007406:Interview, Psychological; D008297:Male; D001523:Mental Disorders / Q000145:classification / Q000175:diagnosis / Q000523:psychology; D008875:Middle Aged; D009771:Obsessive-Compulsive Disorder / Q000145:classification / Q000175:diagnosis* / Q000523:psychology; D010555:Personality Inventory; D012934:Social Isolation; D013239:Stereotyped Behavior