Compulsive hoarders: How do they differ from individuals with obsessive compulsive disorder?

Abstract

Hoarding has been considered a subtype of obsessive–compulsive disorder (OCD). Planned revisions to the diagnostic criteria propose that hoarding form a separate diagnosis in a larger category of obsessive compulsive related disorders. To date, there have been few direct comparisons between hoarding and those with other symptoms of OCD. This study builds on work that suggests compulsive hoarding, while similar to OCD, comprises a clinically distinct condition. Three groups were compared: those with OCD without compulsive hoarding symptoms (n=102), those with compulsive hoarding but not OCD (n=21), and individuals who satisfied both criteria (n=25). The groups were compared on obsessionality, compulsivity, overvalued ideas, depression, and anxiety. The two hoarding groups were also compared on hoarding symptoms and savings cognitions. Results indicated that the hoarding-only group reported fewer symptoms than both OCD groups, including fewer obsessions and compulsions and lower depression. Both hoarding groups showed significantly higher overvalued ideas when compared to the OCD-only group. These results suggest that hoarders experience less subjective distress than those with OCD, yet have greater difficulty in challenging dysfunctional cognitions associated with the presenting condition. These findings suggest that individuals with hoarding, whether with or without OCD, will show greater difficulty engaging in cognitive-behavioral interventions.