Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
PLoS One. 2013 Jul 10;8(7):e69140. doi: 10.1371/journal.pone.0069140. Print 2013.
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. We examined the prevalence, comorbidity and etiology of hoarding symptoms in adolescence.
To 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.
The 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.
Hoarding 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.
囤积症（HD）通常被认为是“老年”问题，但许多被诊断为 HD 的人回顾性地报告说，他们在儿童或青少年时期首次出现症状。我们研究了青少年囤积症状的患病率、共病和病因。
为了确定是否存在临床上显著的囤积症状，对 15 岁的双胞胎进行了一项基于人群的样本调查（N=3974），他们完成了囤积量表自评。父母报告了共病强迫症（OCD）、自闭症谱系障碍（ASD）和注意力缺陷多动障碍（ADHD）。模型拟合分析将囤积症状评分分为加性遗传、共享和非共享环境影响。
临床上显著的囤积症状的患病率为 2%（95%CI 1.6-2.5%），女孩的患病率明显高于男孩。排除杂乱无章的标准（因为青少年无法控制自己的环境）后，患病率上升至 3.7%（95%CI 3.1-4.3%）。在有临床显著囤积症状的人中，有 30-40%的人报告说有过度获取。在囤积和非囤积青少年中，共病 OCD（2.9%）、ASD（2.9%）和 ADHD（10.0%）的患病率相当。模型拟合分析表明，在男孩中，加性遗传（32%；95%CI 13-44%）和非共享环境效应解释了大部分变异。相比之下，在女孩中，共享和非共享环境效应解释了大部分变异，而加性遗传因素的作用微不足道。
囤积症状在青少年中相对普遍，尤其是在女孩中，并且会引起痛苦和/或损伤。囤积症很少与其他常见的神经发育障碍有关，这支持了 DSM-5 将其作为一个独立诊断的地位。遗传和共享环境因素对囤积症的相对重要性因性别而异。这些发现提示了从青春期到成年期运作的动态发育遗传和环境影响。
