Abstract
BackgroundHoarding Disorder (HD) is often assumed to be an ‘old age’ problem, but many individuals diagnosed with HD retrospectively report first experiencing symptoms in childhood or adolescence. We examined the prevalence, comorbidity and etiology of hoarding symptoms in adolescence.MethodsTo determine the presence of clinically significant hoarding symptoms, a population-based sample of 15-year old twins (N = 3,974) completed the Hoarding Rating Scale-Self Report. Co-occurring Obsessive Compulsive Disorder (OCD), Autism Spectrum Disorders (ASD) and Attention Deficit Hyperactivity Disorder (ADHD) were estimated from parental report. Model-fitting analyses divided hoarding symptom scores into additive genetic, shared, and non-shared environmental effects.ResultsThe prevalence of clinically significant hoarding symptoms was 2% (95% CI 1.6–2.5%), with a significantly higher prevalence in girls than boys. Exclusion of the clutter criterion (as adolescents do not have control over their environment) increased the prevalence rate to 3.7% (95% CI 3.1–4.3%). Excessive acquisition was reported by 30–40% among those with clinically significant hoarding symptoms. The prevalence of co-occurring OCD (2.9%), ASD (2.9%) and ADHD (10.0%) was comparable in hoarding and non-hoarding teenagers. Model-fitting analyses suggested that, in boys, additive genetic (32%; 95% CI 13–44%) and non-shared environmental effects accounted for most of the variance. In contrast, among girls, shared and non-shared environmental effects explained most of the variance, while additive genetic factors played a negligible role.ConclusionsHoarding symptoms are relatively prevalent in adolescents, particularly in girls, and cause distress and/or impairment. Hoarding was rarely associated with other common neurodevelopmental disorders, supporting its DSM-5 status as an independent diagnosis. The relative importance of genetic and shared environmental factors for hoarding differed across sexes. The findings are suggestive of dynamic developmental genetic and environmental effects operating from adolescence onto adulthood.
Highlights
Hoarding has been defined as the acquisition of and failure to discard a large number of possessions, difficulties using living spaces due to clutter and significant impairment and/or emotional distress due to the hoarding behavior [1]
Twin zygosity was determined either by using single nucleotide polymorphisms (SNPs) [30] or an algorithm based on twin similarity with predictive value greater than 95% compared to DNA testing [31]
Excessive acquisition was endorsed by 38% (n = 30) of participants with clinically significant hoarding symptoms and by 28% (n = 41) of participants when the clutter criterion was excluded from the prevalence estimates
Summary
Hoarding has been defined as the acquisition of and failure to discard a large number of possessions, difficulties using living spaces due to clutter and significant impairment and/or emotional distress due to the hoarding behavior [1]. Anecdotal evidence and some retrospective studies suggest that the origins of hoarding may be in childhood or adolescence [7,8]. Many patients report specific events in childhood (such as parents forcefully discarding possessions) as the origin of their current problematic behavior [9]. The actual prevalence of hoarding symptoms during childhood and adolescence in the general population remains unknown. Because parental control over the living space may limit the extent and consequences of hoarding in young people, any prevalence estimates should take this into account. Hoarding Disorder (HD) is often assumed to be an ‘old age’ problem, but many individuals diagnosed with HD retrospectively report first experiencing symptoms in childhood or adolescence. Comorbidity and etiology of hoarding symptoms in adolescence
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
