• Quote of the Day
    "Too bad the only people who know how to run the country are busy driving cabs and cutting hair."
    George Burns, posted by David Baxter

David Baxter

Administrator
Joined
Mar 26, 2004
Messages
37,769
Points
113
SRI Medication Effective In Treating Compulsive Hoarding Patients
October 25, 2006

In a paper published on-line in advance of publication in the Journal of Psychiatric Research, Sanjaya Saxena, M.D., Director of the Obsessive-Compulsive Disorders (OCD) Program at the University of California, San Diego (UCSD) School of Medicine, reports the surprising finding that the serotonin reuptake inhibitor (SRI) medication, paroxetine, is effective in treating patients with compulsive hoarding syndrome.

The study of 79 patients diagnosed with obsessive-compulsive disorder (OCD) -- 32 of them with compulsive hoarding syndrome -- suggests that further controlled trials of SRI medications for compulsive hoarding are now warranted.

Compulsive hoarding, which may affect up to 2 million people in the United States, is found in people with many diseases, including anorexia, schizophrenia, Alzheimer's disease and dementia. It is most often found in patients with OCD, though researchers are not yet sure if it is a subtype of OCD or a separate disorder.

In previous, retrospective studies -- looking at patients and data from past drug trials -- compulsive hoarding had been associated with poor response to SRI medications commonly used to treat OCD patients. However, no previous study had ever directly tested this widely held theory. Saxena's prospective study, comparing the hoarding and non-hoarding OCD patients, showed nearly identical responses to paroxetine (commonly known as Paxil.) The symptoms exhibited by patients in both groups improved significantly with treatment.

Compulsive hoarding patients exhibit three core features: failure to discard objects due to severe anxiety related to discarding what most might regard as inconsequential objects; excessive acquisition, sometimes resulting in buying sprees; and excessive clutter to the point where home and work spaces can no longer be used. They also display marked indecisiveness, disorganization, and procrastination. Sometimes such patients are only discovered when a landlord, social worker or fireman enters a home in which every available surface -- floors, tables, sofas and beds -- is covered with clutter making the space inhabitable.

"The syndrome is driven by obsessional fears of not having items you might need, or of losing something valuable, as well as overly sentimental attachments to objects." said Saxena.

Compulsive hoarding is a psychiatric disorder with brain abnormalities that can be seen and measured, according to Saxena, whose research focuses on the neurobiology (brain abnormalities) and treatment of OCD and related mood and anxiety disorders. He points out that the disorder is treatable through a combination of medication and therapy. Saxena and colleagues at UCSD recently opened a new clinic in La Jolla to treat patients with OCD and related disorders, including compulsive hoarding.

Saxena was formerly director of the UCLA Neuropsychiatric Institute's OCD Research Program, where he and his research team used positron emission tomography (PET) brain imaging to discover distinct patterns of brain activity that were associated with compulsive hoarding but not found in non-hoarding OCD patients. Preliminary data from their brain studies also suggest that people with compulsive hoarding are more likely to have mild atrophy or an unusual shape to their frontal lobes, which is the part of the brain associated with executive functions and decision-making. In a few months, the UCSD team will begin a new PET study of compulsive hoarding, as well as a study of hoarding in patients over 55.

"The vast majority of compulsive hoarders have had problems for many years before seeking help," Saxena said, with symptoms that worsen over time. "As patients age and live independently, they may become isolated, and the hoarding syndrome can spin out of control."

Saxena has authored or co-authored over 40 scientific articles and book chapters and has presented his work at many major national and international scientific meetings. He has received awards and grants from the American Psychiatric Association, American Neuropsychiatric Association, National Institute of Mental Health, and the Obsessive-Compulsive Foundation. His research has garnered attention from local and national media, and he has been featured on CNN, the Discovery Channel, the New York Times, Boston Globe and Discover Magazine.

The UCSD Obsessive-Compulsive Disorders Clinic offers specialized assessment, diagnosis and treatment of patients with OCD, compulsive hoarding and other related disorders, such as trichotillomania (hair pulling), body dysmorphic disorder and Tourette Syndrome. Patients can phone the clinic at 858-534-6200 for an appointment.
 

Retired

Member
Joined
Aug 17, 2005
Messages
8,966
Points
36
Compulsive hoarding, .... is found in people with many diseases, including anorexia, schizophrenia, Alzheimer's disease and dementia. It is most often found in patients with OCD, though researchers are not yet sure if it is a subtype of OCD or a separate disorder
.

Does this mean that compulsive hoarding is a co-morbid condition to the disorders listed?

failure to discard objects due to severe anxiety related to discarding what most might regard as inconsequential objects; excessive acquisition, sometimes resulting in buying sprees; and excessive clutter to the point where home and work spaces can no longer be used. They also display marked indecisiveness, disorganization, and procrastination

I have met 2 people who would seem to be described by this definition. One was marginally socially functional while the other was fully functional, worked in a profession, but visiting his home revealed his secret.

Both men lived in houses which were unfinished inside, with only the 2 X 4 partitions and wiring. Both collected a variety of objects, the dysfunctional man collected objects from other people's trash, while the professional collected every possible tool imaginable, far beyond any ability to ever use the tools he collected.
 

just mary

Member
Joined
Nov 3, 2004
Messages
754
Points
16
I have a friend like that also. He'll use all three reasons to hold onto things:

not having items you might need, or of losing something valuable, as well as overly sentimental attachments to objects.

He's also a professional, sociable (he likes to talk and be around people), has a wonderful, supportive family. But his father was also a collector.

But I don't think he would ever be amenable to taking an anti-depressant. He's never smoked or done drugs and he's a very light drinker. He won't even touch coffee though he has no problem drinking coke. He doesn't like drugs of any kind.

I worry about him.

I'm thinking of forwarding this article to him but he probably wouldn't be appreciative.

It was an interesting article all the same.

Thanks,

jm
 

Retired

Member
Joined
Aug 17, 2005
Messages
8,966
Points
36
Our local news is reporting the police arrested a man locally who was discovered to be living with 50 dogs and 100 birds in a little house. All animals were malnourished, living in deplorable conditions and surprisingly, neighbors were unaware of this man's behaviour!

I'm thinking of forwarding this article to him but he probably wouldn't be appreciative

Mary, I have struggled with this for years in connection with Tourette and have always been hesitant to advise someone I suspected of having Tourette without their consent.

I have not reached a comfortable conclusion as yet, and my intuition would suggest you may compromise your relationship with this person if he is not receptive to considering getting help.

What do you think?
 

just mary

Member
Joined
Nov 3, 2004
Messages
754
Points
16
Hi TSOW,

I have not reached a comfortable conclusion as yet, and my intuition would suggest you may compromise your relationship with this person if he is not receptive to considering getting help.

What do you think?

I agree. It was a fleeting thought, once I mulled it over a bit longer - I thought better.

Thanks for the input.

I'm glad he doesn't collect animals though.
 

ThatLady

Member
Joined
Nov 4, 2004
Messages
4,104
Points
36
Heh. Some time ago, someone posted a website on another board that detailed (with pictures) the lamentations of a college student living with his mother. The mother is a hoarder, and you cannot believe what that house looked like. Here's a link but, believe me, you ain't gonna believe it! :D

http://www.badjason.com/RegularArticles/Crazy eBay mom.htm

Do read the comments accompanying the pictures. They're a hoot!
 

just mary

Member
Joined
Nov 3, 2004
Messages
754
Points
16
I have to say "wow" too. Quite the house and the comments were a hoot. :)

The thing is, my friend's house is similar - not quite at that level but close.

I have a feeling this is much more common than thought.

jm.
 

ThatLady

Member
Joined
Nov 4, 2004
Messages
4,104
Points
36
I have to say "wow" too. Quite the house and the comments were a hoot. :)

The thing is, my friend's house is similar - not quite at that level but close.

I have a feeling this is much more common than thought.

jm.

Heh. You might want to share that site with your friend, under the guise of a giggle. Perhaps, the message will penetrate. ;)
 

just mary

Member
Joined
Nov 3, 2004
Messages
754
Points
16
Heh. You might want to share that site with your friend, under the guise of a giggle. Perhaps, the message will penetrate.

My thoughts exactly TL, thanks. :)
 

K9

Member
Joined
Feb 3, 2006
Messages
66
Points
6
Hi All

I checked out the site listed and although I am not that bad I must say I like the fact that this person was an organized horder, which I am not. Not sure if I would be considered a horder but am very disorganized at home with most places around the house being cluttered; don't know where to start tidying up so I tend not to (and yet I hate dirt unless it's my own). Yet at work I have to be very meticulous and organized. Also can't seem to throw anything sentimental away so my family has a clean up or should I say throw out of clothes whilst I am on holidays. Half the time I don't remember what I had. When any papers get thrown away, ie envelopes, old paid bills etc. I need to check them in case there is something I need to keep. About 20+years ago I used to wash my hands a lot (don't do that now so much) but now have a problem with touching public door handles at shopping centre toilets. Does this all sound like I have a few problems?? and what in particular I'm not sure or does it even matter.

K9:)
 

Top Bottom