Department of Epidemiology, University of Florida, 2004 Mowry Road, Gainesville, FL, 32610, USA.
Department of Psychiatry, University of Florida, 100 S Newell Drive, L4-100, Gainesville, FL, 32610, USA.
BMC Psychiatry. 2022 Oct 15;22(1):647. doi: 10.1186/s12888-022-04287-2.
Hoarding symptoms are associated with functional impairment, though investigation of disability among individuals with hoarding disorder has largely focused on clutter-related impairment to home management activities and difficulties using space because of clutter. This analysis assesses disability among individuals with hoarding symptoms in multiple domains of everyday functioning, including cognition, mobility, self-care, interpersonal and community-level interactions, and home management. The magnitude of the association between hoarding and disability was compared to that of medical and psychiatric disorders with documented high disability burden, including major depressive disorder (MDD), diabetes, and chronic pain.
Data were cross-sectionally collected from 16,312 adult participants enrolled in an internet-based research registry, the Brain Health Registry. Pearson's chi-square tests and multivariable logistic regression models were used to quantify the relationship between hoarding and functional ability relative to MDD, diabetes, and chronic pain.
More than one in ten participants endorsed clinical (5.7%) or subclinical (5.7%) hoarding symptoms (CHS and SCHS, respectively). After adjusting for participant demographic characteristics and psychiatric and medical comorbidity, CHS and SCHS were associated with increased odds of impairment in all domains of functioning. Moderate to extreme impairment was endorsed more frequently by those with CHS or SCHS compared to those with self-reported MDD, diabetes, and/or chronic pain in nearly all domains (e.g., difficulty with day-to-day work or school: CHS: 18.7% vs. MDD: 11.8%, p < 0.0001) except mobility and self-care. While those with current depressive symptoms endorsed higher rates of impairment than those with hoarding symptoms, disability was most prevalent among those endorsing both hoarding and comorbid depressive symptoms.
Hoarding symptoms are associated with profound disability in all domains of functioning. The burden of hoarding is comparable to that of other medical and psychiatric illnesses with known high rates of functional impairment. Future studies should examine the directionality and underlying causality of the observed associations, and possibly identify target interventions to minimize impairment associated with hoarding symptomatology.
囤积症状与功能障碍有关，尽管对囤积障碍患者的残疾研究主要集中在与杂物相关的家庭管理活动障碍以及因杂物而导致的空间使用困难上。本分析评估了具有囤积症状的个体在日常生活功能的多个领域中的残疾情况，包括认知、移动、自理、人际和社区层面的互动以及家庭管理。囤积与残疾之间的关联程度与具有高残疾负担的医学和精神疾病（包括重度抑郁症、糖尿病和慢性疼痛）进行了比较。
从参加基于互联网的研究注册中心——大脑健康登记处的 16312 名成年参与者中收集了横断面数据。使用 Pearson's 卡方检验和多变量逻辑回归模型来量化囤积与功能能力相对于重度抑郁症、糖尿病和慢性疼痛之间的关系。
超过十分之一的参与者报告了临床（5.7%）或亚临床（5.7%）囤积症状（CHS 和 SCHS，分别）。在调整了参与者的人口统计学特征以及精神和医学合并症后，CHS 和 SCHS 与所有功能领域的损伤几率增加有关。与自我报告的重度抑郁症、糖尿病和/或慢性疼痛相比，那些有 CHS 或 SCHS 的人在几乎所有领域（例如，日常工作或学校的困难：CHS：18.7% vs. 重度抑郁症：11.8%，p<0.0001）更频繁地报告有中度至重度损伤，除了移动和自理能力。尽管目前有抑郁症状的患者报告的损伤率高于有囤积症状的患者，但在同时有囤积和共病抑郁症状的患者中，残疾最为普遍。
囤积症状与所有功能领域的严重残疾有关。囤积的负担与其他具有已知高功能障碍率的医学和精神疾病相当。未来的研究应该检验所观察到的关联的方向性和潜在因果关系，并可能确定针对最小化与囤积症状相关的损伤的目标干预措施。
