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Hoarders Show Abnormal Brain Activity

Compulsive hoarding is a disorder all of its own, not a symptom of OCD, suggests new brain-imaging research.


Some experience hoarding as an addiction.
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By Valerie Tejeda


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Compulsive hoarding should be treated as a disorder in its own category, suggests new research. The potentially devastating condition has been seen as a symptom of Obsessive Compulsive Disorder (OCD), but a study published in the Archives of General Psychiatry suggests that hoarding is a condition all of its own. Researchers led by Dr. David Tolin of the Institute of Living in Hartford, Connecticut used functional magnetic resonance imaging (fMRI) to measure participants' brain activity as they made decisions about keeping or discarding their possessions. The scans of 43 compulsive hoarders were then compared to the scans of 31 OCD patients and 33 healthy individuals: the hoarders showed abnormal activity in the brain's anterior cingulate cortex and other regions associated with categorization and making decisions. “These differences in neural function correlated significantly with hoarding severity and self-ratings of indecisiveness among patients with hoarding disorder and were unattributable to OCD or depressive symptoms,” says Tolin. He says the study also spotlights “problems in decision-making processes that contribute to patients’ difficulty in discarding items.”

The research is the first of its kind to examine what happens is the brain when people with hoarding disorder are faced with decisions about whether to keep their belongings. “The results are very timely given the current deliberations to include a new diagnostic category in DSM-5 and further delineate the differences between HD and OCD,” says David Mataix-Cols, a professor at the Institute of Psychiatry, King’s College London, and an Advisor to the DSM-5 Obsessive-Compulsive and Related Disorders workgroup. “This is important because until recently hoarding was thought to be a symptom of OCD. Now we know that most hoarders don’t have OCD.”

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