Hoarding in Obsessive-Compulsive Disorder: Clinical and Genetic Correlates
J Clin Psychiatry 2005;66(9):1155-1160
© Copyright 2014 Physicians Postgraduate Press, Inc.
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Objective: Hoarding may be an
important symptom dimension in
obsessive-compulsive disorder (OCD). Hoarding in OCD has been
associated with poor insight, poorer response to
selective serotonin reuptake inhibitors than other
OCD symptom dimensions, and a distinctive psychobiological profile. The clinical and genetic
correlates of hoarding in OCD therefore deserve
Method: Adult OCD patients (N = 315)
underwent a comprehensive clinical assessment that included the Structured Clinical Interview
for DSM-IV Axis I Disorders (Patient Edition) and for Diagnosis of Obsessive-Compulsive
Spectrum Disorders. DNA extracted from venous
blood (10-30 mL) in a Caucasian subset of the
interviewed OCD patients (N = 204) and Caucasian controls (N = 169), including patients
(N = 94) and controls (N = 138) of Afrikaner descent,
was genotyped to investigate polymorphisms in
genes involved in monoamine function and
previously hypothesized to be relevant to OCD. Data
were collected from 1998 through 2004.
Results: OCD patients with hoarding made
up 18.1% of the total sample. Compared with nonhoarding OCD, OCD with hoarding was
associated with a number of comorbid Axis I disorders, obsessive-compulsive
personality disorder, significantly higher OCD
severity scores, and more functional impairment. In
subjects of Afrikaner descent, the L/L genotype of
the COMT Val158Met polymorphism was significantly more common in the OCD hoarding
group, with a preponderance of low activity alleles,
compared with nonhoarding patients and controls.
Conclusions: These data are consistent
with the hypothesis that hoarding represents a
unique symptom subtype in OCD with a distinctive
clinical and psychobiological profile. Further work
is needed to determine the psychobiological mechanisms responsible for hoarding and to
replicate the genetic findings noted here.