The profile of executive function in OCD hoarders and hoarding disorder.
Hoarding disorder is a new mental disorder in DSM-5. It is classified alongside OCD and other presumably related disorders in the Obsessive-Compulsive and Related Disorders chapter. We examined cognitive performance in two distinct groups comprising individuals with both OCD and severe hoarding, and individuals with hoarding disorder without comorbid OCD. Participants completed executive function tasks assessing inhibitory control, cognitive flexibility, spatial planning, probabilistic learning and reversal and decision making. Compared to a matched healthy control group, OCD hoarders showed significantly worse performance on measures of response inhibition, set shifting, spatial planning, probabilistic learning and reversal, with intact decision making. Despite having a strikingly different clinical presentation, individuals with only hoarding disorder did not differ significantly from OCD hoarders on any cognitive measure suggesting the two hoarding groups have a similar pattern of cognitive difficulties. Tests of cognitive flexibility were least similar across the groups, but differences were small and potentially reflected subtle variation in underlying brain pathology together with psychometric limitations. These results highlight both commonalities and potential differences between OCD and hoarding disorder, and together with other lines of evidence, support the inclusion of the new disorder within the new Obsessive-Compulsive and Related Disorders chapter in DSM-5.
Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, UK; Department of Psychiatry, University of Cambridge, Cambridge, UK; Department of Psychology, University of Cambridge, Cambridge, UK. Electronic address: sm658@cam.ac.uk.
Sharon
S
Morein-Zamir
Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, UK; Department of Psychology, University of Cambridge, Cambridge, UK.
Martina
M
Papmeyer
Departments of Psychology and Psychosis Studies, King's College London, Institute of Psychiatry, London, UK.
Alberto
A
Pertusa
Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, UK; Department of Psychiatry, University of Cambridge, Cambridge, UK.
Samuel R
SR
Chamberlain
Mental Health Unit, QEII Hospital, Welwyn Garden City, Hertfordshire, UK.
Naomi A
NA
Fineberg
Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, UK; Department of Psychiatry, University of Cambridge, Cambridge, UK.
Barbara J
BJ
Sahakian
Department of Psychology, University of Cambridge, Cambridge, UK; Departments of Psychology and Psychosis Studies, King's College London, Institute of Psychiatry, London, UK.
David
D
Mataix-Cols
Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, UK; Department of Psychology, University of Cambridge, Cambridge, UK.
Trevor W
TW
Robbins
D000328:Adult; D016022:Case-Control Studies; D003071:Cognition / Q000502:physiology; D015897:Comorbidity; D003192:Compulsive Behavior; D003657:Decision Making / Q000502:physiology*; D056344:Executive Function / Q000502:physiology*; D005260:Female; D000067836:Hoarding Disorder / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology; D006801:Humans; D007266:Inhibition, Psychological; D008297:Male; D009771:Obsessive-Compulsive Disorder / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology; D011569:Psychiatric Status Rating Scales; D011594:Psychometrics
Cognition; Hoarding; Hoarding disorder; Obsessive compulsive disorder (OCD)