Compulsive hoarding: OCD symptom, distinct clinical syndrome, or both?
Compulsive hoarding: OCD symptom, distinct clinical syndrome, or both?
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DOI：
10.1176/appi.ajp.2008.07111730
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发表时间：
2008-10
期刊：
影响因子：
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通讯作者：
A. Pertusa;M. Fullana;Satwant Singh;P. Alonso;J. Menchón;D. Mataix-Cols
中科院分区：
文献类型：
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作者：
A. Pertusa;M. Fullana;Satwant Singh;P. Alonso;J. Menchón;D. Mataix-Cols
目的强迫性囤积是一种使人衰弱的问题，常与强迫性精神障碍（OCD）和强迫性人格障碍有关。然而，强迫性囤积症的确切疾病分类尚未确定。方法对25例重度强迫性囤积症合并强迫症患者和27例重度强迫性囤积症不伴强迫症患者进行研究。这两组仔细的特点，并在以下社会人口和临床变量进行比较：囤积行为的精确现象，其他强迫症症状的严重程度，轴I和轴II精神病理学，和适应功能。为了比较的目的，还招募了以下个体：71名无囤积症的强迫症患者，19名焦虑症患者和21名社区参与者。结果总体而言，两个囤积组的囤积行为现象相似。两组中的大多数参与者都报告说，由于情感和/或内在价值而囤积共同物品。然而，强迫囤积强迫症组中约有四分之一的参与者表现出不同的精神病理学特征，其特征是囤积奇怪的物品以及与囤积有关的其他强迫和强迫行为，例如害怕灾难性后果，需要进行检查仪式，以及在丢弃任何物品之前需要进行精神强迫。这些患者有一个更严重和致残形式的障碍。强迫性囤积和强迫性人格障碍之间的密切关系完全可以通过重叠的项目内容来解释。结论：在大多数个体中，强迫性囤积似乎是一种独立于强迫症的综合征，强迫症与相当程度的残疾和社会孤立有关。然而，在其他个体中，强迫性囤积可能被认为是强迫症的症状，并具有独特的临床特征。这些发现对下一版DSM中强迫症和强迫性囤积的分类具有启示意义。
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. METHOD 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.