Department of Medicine, University of Florida, Gainesville, FL, United States; Department of Psychiatry, University of Florida, Gainesville, FL, United States; Center for OCD, Anxiety and Related Disorders, University of Florida, Gainesville, FL, United States.
Department of Psychiatry, University of Florida, Gainesville, FL, United States; Center for OCD, Anxiety and Related Disorders, University of Florida, Gainesville, FL, United States.
J Psychiatr Res. 2022 Dec;156:16-24. doi: 10.1016/j.jpsychires.2022.09.037. Epub 2022 Sep 27.
The relationships between hoarding disorder (HD) and other neurological and psychiatric disorders remain largely unknown. Although psychiatric burden in those with HD is high, less is known about neurological disorders. Furthermore, which disorders are primarily associated with HD vs which can be better explained via a relationship with another disorder has not been determined. To address these questions, we examined comorbidity patterns of psychiatric and neurological disorders in a large online registry of adults using network analyses.
We first examined psychiatric comorbidity among 252 participants completing clinician administered psychiatric assessments. Using the Brain Health Registry (BHR) (N = 15,978), we next analyzed prevalence of self-reported neurological and psychiatric disorders among participants with no/minimal hoarding, subclinical hoarding, and clinically significant hoarding and used network analyses to identify direct and indirect relationships between HD and the assessed psychiatric and neurological disorders.
The most prevalent comorbidity in clinically assessed participants with HD was major depressive disorder (MDD, 62%), followed by generalized anxiety disorder (GAD, 32%). Network analyses in the BHR indicated that the strongest direct relationships with HD were attention-deficit hyperactivity disorder (ADHD), major depressive disorder (MDD), and obsessive-compulsive disorder (OCD). The relationships between HD and neurological disorders, including mild cognitive impairment, were weak or non-existent after controlling for other disorders.
ADHD, MDD, and OCD form a triad of psychiatric disorders directly associated with HD. Despite their high comorbidity rates, the associations among anxiety disorders and HD were weak or indirect.
囤积症(HD)与其他神经和精神障碍之间的关系在很大程度上尚不清楚。尽管 HD 患者的精神负担很高,但对神经障碍的了解却较少。此外,哪些疾病主要与 HD 相关,哪些疾病与另一种疾病的关系可以更好地解释,尚未确定。为了解决这些问题,我们使用网络分析方法在一个大型的成人在线登记处研究了精神和神经障碍的共病模式。
我们首先检查了 252 名完成临床医生进行的精神评估的参与者的精神共病情况。使用脑健康登记处(BHR)(N=15978),我们接下来分析了无/轻度囤积、亚临床囤积和临床显著囤积患者中自我报告的神经和精神障碍的患病率,并使用网络分析来识别 HD 与评估的精神和神经障碍之间的直接和间接关系。
HD 临床评估参与者中最常见的共病是重度抑郁症(MDD,62%),其次是广泛性焦虑症(GAD,32%)。BHR 中的网络分析表明,与 HD 直接关系最强的是注意力缺陷多动障碍(ADHD)、重度抑郁症(MDD)和强迫症(OCD)。在控制其他疾病后,HD 与神经障碍之间的关系,包括轻度认知障碍,很弱或不存在。
ADHD、MDD 和 OCD 构成了与 HD 直接相关的精神障碍三联症。尽管焦虑症与 HD 的共病率很高,但它们之间的关联是微弱的或间接的。