Bratiotis Christiana, Muroff Jordana, Lin Nancy X Y
School of Social Work, University of British Columbia, Vancouver, British Columbia, Canada (Bratiotis, Lin);School of Social Work, Boston University, Boston (Muroff).
Focus (Am Psychiatr Publ). 2021 Oct;19(4):392-404. doi: 10.1176/appi.focus.20210016. Epub 2021 Nov 5.
Hoarding disorder is characterized by difficulty parting with possessions because of strong urges to save the items. Difficulty discarding often includes items others consider to be of little value and results in accumulation of a large number of possessions that clutter the home. Cognitive-behavioral therapy (CBT) with exposure and response prevention and selective serotonin reuptake inhibitor medications traditionally used to treat obsessive-compulsive disorder are generally not efficacious for people with hoarding problems. A specialized CBT approach for hoarding has shown progress in reaching treatment goals and has been modified to be delivered in group, peer-facilitated, and virtual models. Research on hoarding remains in the early phases of development. Animal, attachment, and genetic models are expanding. Special populations, such as children, older adults, and people who do not voluntarily seek treatment need special consideration for intervention. Community-based efforts aimed at reducing public health and safety consequences of severe hoarding are needed.
囤积障碍的特征是由于强烈的保存物品的冲动而难以舍弃财物。难以丢弃的物品通常包括他人认为价值不大的东西，这会导致大量财物堆积，使家里杂乱不堪。传统上用于治疗强迫症的认知行为疗法（CBT），即暴露与反应阻止疗法，以及选择性5-羟色胺再摄取抑制剂药物，对有囤积问题的人通常没有效果。一种专门针对囤积的认知行为疗法在实现治疗目标方面已取得进展，并且已被修改以采用团体、同伴辅助和虚拟模式进行治疗。关于囤积的研究仍处于早期发展阶段。动物模型、依恋模型和遗传模型正在不断扩展。特殊人群，如儿童、老年人以及那些不主动寻求治疗的人，在干预时需要特别考虑。需要开展基于社区的努力，以减少严重囤积行为对公众健康和安全造成的影响。
