title: Neurocognitive performance in unmedicated patients with hoarding disorder.
abstract: OBJECTIVE
  Hoarding disorder (HD) is an often incapacitating psychiatric illness associated with a wide range of neurocognitive abnormalities. Some prior neuropsychological studies have found executive dysfunction in HD, but no clear pattern has emerged. One potential reason for discrepant results in previous studies might be the inclusion of patients on psychotropic and other medications that can affect neurocognitive performance. Therefore, we examined neurocognitive functioning in medication-free HD patients. We also added a novel investigation of implicit learning, which has been found to be abnormal in obsessive-compulsive disorder (OCD) and related disorders.
  
  
  METHODS
  Twenty-six participants meeting the Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5; American Psychiatric Association, 2013) diagnostic criteria for HD and 23 normal controls were administered a battery of neuropsychological tests and symptom rating scales. All participants were free of psychotropic medications for at least 6 weeks prior to the study.
  
  
  RESULTS
  HD participants showed no significant differences from normal controls on measures of verbal memory, attention, or executive functioning, including response inhibition, planning, organization, and decision making. However, HD participants demonstrated a trend toward less implicit learning and greater use of explicit learning strategies during perceptual categorization compared to normal controls. HD participants who used an implicit strategy performed significantly worse than controls who used an implicit strategy. Hoarding symptom severity was not associated with neurocognitive performance.
  
  
  CONCLUSIONS
  HD patients may have a tendency to use explicit rather than implicit learning strategies for perceptual categorization but perform as well as normal controls on many other neurocognitive measures. Future studies should assess unmedicated participants and examine test strategies, not just outcomes.
authors: Department of Psychiatry, University of California, San Diego School of Medicine.
authors: Jennifer M
authors: JM
authors: Sumner
authors: Department of Psychiatry, University of California, San Diego School of Medicine.
authors: Carolyn G
authors: CG
authors: Noack
authors: Department of Psychiatry, University of California, San Diego School of Medicine.
authors: J Vincent
authors: JV
authors: Filoteo
authors: Department of Psychology, University of Texas at Austin.
authors: W Todd
authors: WT
authors: Maddox
authors: Department of Psychiatry, University of California, San Diego School of Medicine.
authors: Sanjaya
authors: S
authors: Saxena
mesh_terms: D000328:Adult; D001288:Attention; D016022:Case-Control Studies; D003657:Decision Making; D039721:Diagnostic and Statistical Manual of Mental Disorders; D056344:Executive Function; D005260:Female; D000067836:Hoarding Disorder / Q000175:diagnosis / Q000523:psychology*; D006801:Humans; D007266:Inhibition, Psychological; D007858:Learning; D008297:Male; D008568:Memory; D008875:Middle Aged; D009483:Neuropsychological Tests