Neurobiology and treatment of compulsive hoarding.
Compulsive hoarding is a common and often disabling neuropsychiatric disorder. This article reviews the phenomenology, etiology, neurobiology, and treatment of compulsive hoarding. Compulsive hoarding is part of a discrete clinical syndrome that includes difficulty discarding, urges to save, clutter, excessive acquisition, indecisiveness, perfectionism, procrastination, disorganization, and avoidance. Epidemiological and taxometric studies indicate that compulsive hoarding is a separate but related obsessive-compulsive spectrum disorder that is frequently comorbid with obsessive-compulsive disorder (OCD). Compulsive hoarding is a genetically discrete, strongly heritable phenotype. Neuroimaging and neuropsychological studies indicate that compulsive hoarding is neurobiologically distinct from OCD and implicate dysfunction of the anterior cingulate cortex and other ventral and medial prefrontal cortical areas that mediate decision-making, attention, and emotional regulation. Effective treatments for compulsive hoarding include pharmacotherapy and cognitive-behavioral therapy. More research will be required to determine the etiology and pathophysiology of compulsive hoarding, and to develop better treatments for this disorder.
Obsessive-Compulsive Disorders Program, University of California, San Diego, CA 92037, USA. ssaxena@ucsd.edu
Sanjaya
S
Saxena
D015928:Cognitive Behavioral Therapy; D003131:Combined Modality Therapy; D003192:Compulsive Behavior / Q000175:diagnosis / Q000235:genetics / Q000503:physiopathology* / Q000628:therapy; D003657:Decision Making; D006179:Gyrus Cinguli / Q000503:physiopathology; D006801:Humans; D009042:Motivation; D009771:Obsessive-Compulsive Disorder / Q000175:diagnosis / Q000235:genetics / Q000503:physiopathology* / Q000628:therapy; D010641:Phenotype; D049268:Positron-Emission Tomography; D017397:Prefrontal Cortex / Q000503:physiopathology; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use; D013239:Stereotyped Behavior / Q000502:physiology*
D017367:Selective Serotonin Reuptake Inhibitors