Patients with obsessive-compulsive disorder and hoarding symptoms: A distinctive clinical subtype?☆

Abstract 

We investigated whether patients with obsessive-compulsive disorder (OCD) and hoarding symptoms can be differentiated from their counterparts with other types of obsessions and compulsions in terms of sociodemographic and clinical features. Ninety-seven patients with OCD were assessed with a sociodemographic and clinical questionnaire, the Structured Clinical Interview for DSM-IV (SCID-I), the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS), the Beck Depression Inventory (BDI), the Hamilton Rating Scale for Depression (HDRS), and the Global Assessment of Functioning (GAF). Fifteen patients who reported hoarding symptoms in the Y-BOCS checklist (15.6% of the total sample) were compared and contrasted with 82 patients without those symptoms using the Mann-Whitney U test for continuous variables and the Pearson’s goodness-of-fit chi-square test for categorical ones; Fisher’s exact test was employed when indicated. Hoarders were characterized by (1) higher educational levels (χ² = 7.49; df = 2; P = .02); (2) earlier age at onset (Z = −2.99; P = .003); (3) higher rates of symmetry obsessions (χ² = 7.03; df = 1; P = .01); (4) greater frequency of ordering (χ² = 10.08; df = 1; P = .004); (5) rituals repetition (χ² = 4.42; df = 1; P = .03); (6) counting compulsions (χ² = 5.92; df = 1; P = .02); and (7) significantly higher rates of comorbidity with bipolar II disorder (χ² = 10.62; df = 1; P = .02) and (8) with eating disorders (χ² = 7.42; df = 1; P = .02). In conclusion, patients with OCD exhibiting hoarding feature a distinctive sociodemographic and clinical profile. It remains to be investigated whether these phenotypical characteristics are underlined by specific neurobiological mechanisms.