Department of Psychosis Studies, King's College London, Institute of Psychiatry, London, England.
Behav Res Ther. 2010 Oct;48(10):1012-20. doi: 10.1016/j.brat.2010.07.003. Epub 2010 Jul 29.
Hoarding, the excessive collection and failure to discard objects of apparently little value, can represent a serious psychiatric problem and pose a threat to public health. Hoarding has traditionally been considered a symptom (or symptom dimension) of Obsessive-Compulsive Disorder (OCD), but its nosological status has recently been debated. Mounting evidence suggests that, once other primary causes are ruled out, hoarding may be a discrete diagnostic entity, recently named Hoarding Disorder. However, hoarding can sometimes be a genuine OCD symptom. This can be confusing and clinicians may sometimes struggle making the differential diagnosis. To illustrate this, we describe 10 OCD patients with severe hoarding behavior that is better conceptualized as a symptom of OCD. We focus on the motivations for hoarding and the overlapping of hoarding with other obsessive-compulsive symptom dimensions. We estimate that this clinical presentation is relatively rare and accounts for a minority of severe hoarding cases. We discuss the unique characteristics of hoarding as a symptom of OCD and the implications for DSM-V.
囤积症，即过度收集和无法舍弃明显价值不高的物品，可能代表一种严重的精神科问题，并对公众健康构成威胁。囤积症传统上被认为是强迫症（OCD）的一种症状（或症状维度），但其分类学地位最近备受争议。越来越多的证据表明，一旦排除其他主要病因，囤积症可能是一种独立的诊断实体，最近被命名为囤积症。然而，囤积有时也可能是真正的强迫症症状。这可能会令人困惑，临床医生有时可能难以进行鉴别诊断。为了说明这一点，我们描述了 10 名 OCD 患者的严重囤积行为，这些行为最好被视为 OCD 的一种症状。我们关注囤积的动机以及囤积与其他强迫症状维度的重叠。我们估计这种临床表现相对较少，占严重囤积病例的少数。我们讨论了 OCD 症状中囤积的独特特征及其对 DSM-V 的影响。
