Hoarding

The inability to discard useless or worn out possessions, commonly referred to as 'hoarding' has long been thought of as an OCD obsession. Hoarding is usually classified as obsessive-compulsive disorder. New research into the brain patterns of compulsive hoarders shows the disorder may have been misclassified in the past. Hoarders with OCD have a different pattern of glucose (sugar) metabolism in the brain than do non-hoarding OCD patients. This would suggest that hoarding may be a distinct type of obsessive-compulsive disorder.

Hoarding is often a specific symptom of OCD which results in people keeping large amounts of items that to the outside world are considered excessive or worthless/useless. It was found to occur in about 30% of individuals with OCD, and in twice as many males as females.

The signs of a compulsive hoarder are the following:

Compulsive acquisition - hoarders acquire extras of things, just in case, more than they'll ever use.

Disorganisation - hoarders find organization difficult, so things end up in haphazard piles.

Difficulty discarding - they really can't throw anything away without severe anxiety.

Hoarding is usually classified as obsessive-compulsive disorder, a catch-all term for a range of symptoms such as constantly repeating actions like hand washing or checking to make sure a stove is turned off. New research into the brain patterns of compulsive hoarders shows the disorder may have been misclassified.

Dr. Sanjaya Saxena from the University of California who led the study said in a statement. "Our work shows that hoarding and saving compulsions long associated with OCD may spring from unique, previously unrecognised neurobiological malfunctions that standard treatments do not necessarily address” Dr Saxena added that “The results emphasize the need to rethink how we categorize psychiatric disorders. Diagnosis and treatment should be driven by biology rather than symptoms," Writing in the American Journal of Psychiatry, Saxena and colleagues described experiments using forty five adults with obsessive-compulsive disorder, twelve of whom were hoarders, and seventeen people without mental health conditions. None were on medication. They used Positron Emission Tomography or PET scans to image brain activity in the volunteers.

The study identified lower brain activity in the anterior cingulate gyrus of compulsive hoarders, compared with other OCD patients. This brain structure helps govern decision-making, focused attention, motivation and problem-solving, cognitive functions that are frequently impaired in compulsive hoarders. The study also found a correlation between the severity of hoarding symptoms and the lower brain activity in the anterior cingulate gyrus (mentioned above) across all of the study subjects with OCD. In addition, the hoarding group showed decreased brain activity in the posterior cingulate gyrus compared to healthy control subjects who had no OCD symptoms. The posterior cingulate gyrus is involved in spatial orientation and memory. The decreased activity in hoarders may explain why they have difficulty with excessive clutter and fear of losing belongings.

The researchers at University of California, Los Angeles say their work suggests some hoarders may have been receiving inappropriate treatment. Standard therapies for OCD often seem to have little effect at reducing these particular symptoms.

Dr Naomi Fineberg says that the finding wasn't a surprise. She stated that "When you are looking at obsessional patients, hoarders seem to stand apart, and they don't respond well - if at all - to standard anti-obsessional treatments, which makes you think they might be a bit different. OCD is probably a mix of different disorders. In fact there is probably a fairly broad spectrum of obsessional disorders."

Dr Fineberg also said that many hoarders did not come forward for treatment. Unlike other forms of OCD in which patients often recognise their behaviour as irrational and senseless, hoarders tended to believe they were acting rationally, and did not need help.

Tips and suggestions for Hoarders
Throw things away straightaway without checking.
Throw things away at times the refuse collectors are coming.
Get help sorting.
Get a paper shredder.
If you cant remember the reason why you have it, get rid of it.
Buy things in limited quantities.
Stop junk mail, newspapers etc.
Set reasonable targets.
Carers and family members should change the subject when the sufferer gets angry.

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