A pilot exploration of ADHD symptoms in hoarding disorder: Co-occurring disorders or part of the hoarding syndrome?

Abstract

Symptoms of ADHD are common in individuals with hoarding disorder (HD). It remains unclear whether these attentional symptoms reflect high co-occurrence rates of ADHD and HD, or whether inattentive symptoms can be conceptualized as intrinsic to the HD syndrome. In addition, inattention (vs. hyperactivity) in particular, appears to be related to HD, but this may be because some inattention criteria (e.g., losing items, disorganization) may be better explained as a result of clutter rather than inattention per se. We explored what specific ADHD symptoms were most likely to be endorsed by individuals with HD, and compared this to a sample of patients with OCD (who have been shown to have some overlapping executive functioning deficits) and a sample of healthy controls. We also examined retrospective ratings of childhood ADHD symptoms to explore whether childhood ADHD symptoms were associated with later HD diagnosis, or whether attentional symptoms in HD onset later in life. Individuals with HD reported higher ADHD symptoms in childhood than did individuals with OCD, and for both clinical groups ADHD symptoms appeared to worsen across the lifespan. Individuals with HD were more likely than were individuals with OCD and healthy controls to endorse inattention subscale items, although the few hyperactive subscale items that were significant appeared to largely reflect verbal impulsivity (e.g., interrupting others, talking too much, “blurting out” responses preemptively). Specific criteria endorsed varied by diagnosis, suggesting that individuals with HD may have a different, specific inattention profile.