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Researchers Discover New Mental Disorder
Date Posted: 17/Feb/2015

If you or someone you know finds it difficult letting go of old items even when it’s taking up all the space in the house, then you may be suffering from a new form of brain disorder called Hoarding Disorder (HD).

In the home of a hoarder, piles of trash may reach the ceiling; stacks of newspapers will crowd the kitchen making cooking impossible. Sleeping, eating and bathing may take place in such clutters, having guests can be out of the question! While some may dismiss this as laziness or untidiness, researchers describe this as a classical sign of HD which is a form of mental disorder.

Findings from a new study by Yale University School of Medicine, published online in Archives of General Psychiatry, described HD as the excessive acquisition of and inability to discard objects, resulting in debilitating clutter.

“Hoarders not only collect too many things, they feel unable to throw them out even if they’re useless.They don’t have one can opener, they have 40,” says Regina Lark, PhD, of the National Association of Professional Organizers.

“Their bathroom has become storage units and you can’t walk up the stairs. Falls and fires are two big dangers they risk, they pile up stuff in ways that are unsafe or affect their dealings with others”, she said.

In 2013, hoarding disorder was named a distinct mental illness with about 2- 5% diagnosis. Some researchers think that severe hoarding may be a form of obsessive-compulsive disorder (OCD) while another study suggests hoarding may sometimes be related to dementia.

A new US study shows for the first time that a particular brain region becomes overactive when hoarders are asked to dispose of their own possessions.

However, the same part of the brain is under- active when hoarders are asked what to do about items not belonging to them.

The study suggests hoarding disorder exists in its own right, and is not just a symptom of Obsessive Compulsive Disorder (OCD) as doctors have long thought.

The findings may also partly explain why people have different attitudes toward per sonal possessions, even if they don’t have a full-blown disorder.

In the study, researchers led by David Tolin of the Institute of Living, Hartford, Connecticut USA, used functional magnetic resonance imaging (fMRI) to measure brain activity when decisions had to be made about whether to keep or discard possessions.

The brain scans compared the reactions of 43 patients diagnosed with hoarding disorder, with 31 patients with obsessive compulsive disorder and a group of 33 healthy individuals.

The objects used in the study were paper items, such as junk mail and newspapers, that either did or did not belong to the participants.

The researchers found patients with hoarding disorder had abnormal activity in the anterior cingulate cortex and other regions involved with decision-making and categorization.

When deciding about items that did not belong to them, the patients had relatively low activity in those brain regions.

But when asked to decide about the fate of items that did belong to them, these regions showed ‘excessive functional magnetic resonance imaging signals’ compared with the other two groups.

Dr Tolin said ‘These differences in neural function correlated significantly with hoarding severity and self-ratings of indecisiveness among patients with hoarding disorder and were unattributable to OCD or depressive symptoms.’

He said the findings suggest ‘problems in decision-making processes that contribute to patients’ difficulty in discarding items’.

The hoarders chose to discard significantly fewer of their own possessions than those from the other two groups.

British experts while supporting this finding said it would help to classify hoarding disorder as a distinct mental health problem.

Prof David Mataix-Cols, from the Institute of Psychiatry, King’s College London said; ‘The difficulty to discard possessions, even those of little apparent value, is one of the landmark features of the newly proposed Hoarding Disorder (HD).

‘Decision-making difficulties are thought to contribute to the inability to discard possessions.

‘This study is the first to investigate what happens in the brain when individuals with Hoarding Disorder make decisions about what to keep and what to discard.

‘The results are very timely given the current deliberations to further delineate the differences between HD and OCD.

This is important because until recently hoarding was thought to be a symptom of OCD. Now we know that most hoarders don’t have OCD.

‘However, like most neuroimaging studies, the results only describe the brain regions implicated in deciding whether or not to discard items but do not explain the causes of such difficulties in individuals with HD.

The guideline for the treatment and prevention of hoarding disorder according to the Mayo clinic is for the hoarder to try to keep up personal hygiene.

“Because hoarding is a fairly recently recognized disorder, research in effective treatments is only starting to pick up. Some methods, though, have shown notable success, including medication and cognitivebehavioral therapy.

Cognitive-behavioral therapy focuses on pinpointing the cognitive (thought-based) causes of compulsive hoarding, typically the roots of anxiety, and then slowly changing the behaviour. It can take months or years, and requires great dedication to the process of recovery, but it can ultimately help a hoarder to let go of the possessions that are interfering with a healthy life.

The best way to increase the chances of overcoming a hoarding problem is to catch it in its early stages”, it says.

So if you see signs in yourself, or you suspect someone you love might be headed down the path of hoarding disorder, reach out. Hoarding is not about laziness or sloppiness or being a “gross” person. It’s a manifestation of a deeper emotional problem, and immediate attention can help nip it in the bud.

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