UCLA Semel Institute for Neuroscience and Human Behavior, Los Angeles, CA; University of Denver, CO.
Johns Hopkins University, Baltimore, MD.
J Am Acad Child Adolesc Psychiatry. 2019 Aug;58(8):799-805. doi: 10.1016/j.jaac.2019.01.017. Epub 2019 Mar 12.
Although adult hoarding disorder is relatively common and often debilitating, few studies have examined the phenomenology of pediatric hoarding. We examined the clinical phenomenology and response to cognitive-behavioral therapy (CBT) treatment in youths with a diagnosis of obsessive-compulsive disorder (OCD) with and without hoarding symptoms. Age was tested as a moderator across analyses, given prior findings that the impact of hoarding symptoms may not become apparent until adolescence.
Youths (N = 215; aged 7-17 years) with OCD pursuing evaluation and/or treatment at a university-based specialty clinic participated in the current study. Presence of hoarding symptoms was assessed as part of a larger battery. Data from a subset of youths (n = 134) who received CBT were included in treatment response analyses.
Youths with hoarding symptoms did not differ from those without hoarding symptoms with respect to overall OCD symptom severity and impairment. Youths with hoarding met criteria for more concurrent diagnoses, including greater rates of internalizing and both internalizing/externalizing, but not externalizing-only, disorders. Youths with and without hoarding symptoms did not significantly differ in rate of response to CBT. Age did not moderate any of these relationships, suggesting that the presence of hoarding symptoms was not associated with greater impairments across the clinical presentation of OCD or its response to treatment by age.
We found no evidence that hoarding is associated with greater OCD severity or poorer treatment response in affected youth. Theoretical and clinical implications of these findings, including future directions for research on testing developmental models of hoarding across the lifespan, are discussed.
尽管成人囤积障碍较为常见且通常会使人衰弱，但很少有研究探讨儿科囤积障碍的现象学。我们研究了患有强迫症（OCD）且伴有和不伴有囤积症状的青少年的临床现象学和认知行为治疗（CBT）治疗反应。鉴于先前的研究发现，囤积症状的影响可能要到青春期才会显现，因此我们在分析中测试了年龄作为调节因素。
在一所大学专科诊所接受评估和/或治疗的患有 OCD 的青少年（N=215；年龄 7-17 岁）参与了当前研究。囤积症状的存在是作为更大电池的一部分进行评估的。接受 CBT 的一部分青少年（n=134）的数据包含在治疗反应分析中。
有囤积症状的青少年在 OCD 的整体症状严重程度和障碍方面与没有囤积症状的青少年没有差异。有囤积症状的青少年符合更多同时存在的诊断标准，包括更高的内化和内化/外化率，但不存在仅外化率。有和没有囤积症状的青少年对 CBT 的反应率没有显著差异。年龄没有调节这些关系中的任何一个，这表明囤积症状与 OCD 的临床表现或其对治疗的反应的严重程度无关。
我们没有发现囤积症与受影响青少年的 OCD 严重程度或治疗反应较差有关的证据。讨论了这些发现的理论和临床意义，包括在整个生命周期测试囤积发展模型的未来研究方向。
