Presence of hoarding symptoms does not negatively impact cognitive behavioral therapy response in youth with OCD
Washington DC, July 23, 2019
Hoarding can often be a debilitating problem for adults and is often associated with poorer mental health functioning and response to treatment. For children however, that may not be the case. A new study in the Journal of the American Academy of Child and Adolescent Psychiatry (JAACAP), published by Elsevier, reveals that cognitive-behavioral therapy (CBT) used to treat obsessive-compulsive disorder (OCD) can be successful for youth with hoarding symptoms. Hoarding has historically been closely associated with OCD but is now considered in its own category in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) and is a phenomenon that is increasingly being discussed in the media. “While evidence in adults suggests that hoarding can be debilitating and interfere with a patient’s ability to benefit from CBT, we found that the presence of hoarding symptoms does not interfere with treatment response to CBT for pediatric OCD,” said lead author Michelle Rozenman, PhD, Assistant Professor at the University of Denver, Denver, CO, and Adjunct Assistant Professor at the UCLA Semel Institute for Neuroscience & Human Behavior, Los Angeles, CA, USA.
“Pediatric hoarding symptoms are prevalent, as nearly half of all youth affected by OCD also experience hoarding symptoms. Given the contrast between our data and studies of hoarding in adulthood that suggest poorer CBT treatment response, clinicians should assess for hoarding in their pediatric OCD patients in order to address these symptoms prior to adulthood when symptoms may worsen and interfere with an individual’s functioning,” Dr. Rozenman added.
The findings are based on data from children and adolescents presenting for services at the UCLA Child OCD, Anxiety, and Tic Disorders Program, a university-based specialty research and clinical program directed by John Piacentini, PhD.
A cohort of 215 children and adolescents between the ages of 7 to 17 who received a primary diagnosis of OCD were enrolled. The authors found that a substantial proportion of OCD-affected youth (43 percent) reported hoarding symptoms.
Evidence-based clinical interviews were conducted to determine OCD and other psychiatric diagnoses, OCD symptom severity and impairment, and presence of hoarding symptoms. A subsample of 134 youth were enrolled in research clinical trials where they received 12 sessions of CBT, with OCD symptom severity and impairment also assessed at the end of treatment.
OCD-affected youth with hoarding symptoms had a higher number of concurrent psychiatric diagnoses on average than those without hoarding symptoms (1.5 vs. 0.78). However, OCD-affected youth with hoarding symptoms did not differ from those without hoarding symptoms in regard to OCD symptom severity and impairment.
The investigators also found that the proportion of OCD-affected youth with hoarding symptoms did not differ from those without hoarding in their treatment response to CBT (50 percent vs. 60 percent), or in improvements in OCD symptom severity.
Importantly, age did not influence any of these relationships, suggesting that the findings apply across childhood and adolescence.
Notes for editors
The article is "Hoarding Symptoms in Children and Adolescents With Obsessive-Compulsive Disorder: Clinical Features and Response to Cognitive-Behavioral Therapy,” by Michelle Rozenman, PhD, Joseph McGuire, PhD, Monica Wu, PhD, Emily Ricketts, PhD, Tara Peris, PhD, Joseph O’Neill, PhD, R. Lindsey Bergman, PhD, Susanna Chang, PhD, John Piacentini, PhD (https://doi.org/10.1016/j.jaac.2019.01.017). It currently appears on the JAACAP Articles In Press page and will appear in the Journal of the American Academy of Child and Adolescent Psychiatry, volume 58, issue 8 (August 2019), published by Elsevier.
Dr. Rozenman is a clinical psychologist, an Assistant Professor in the Department of Psychology at the University of Denver, and adjunct Assistant Professor at the UCLA Semel Institute for Neuroscience & Human Behavior. Her research focuses on improving the efficiency of treatments for children and adolescents with anxiety-related disorders. She has a particular interest in identifying mechanisms underlying anxiety and OCD, and subsequently adapting or developing treatments to modify these processes.
Copies of this paper are available to credentialed journalists upon request; please contact Mary Billingsley at email@example.com or +1 202 587 9672. Journalists wishing to interview the authors may contact Michelle Rozenman, PhD, University of Denver, 2155 S. Race St., Denver, CO 80210 at firstname.lastname@example.org.
Journal of the American Academy of Child and Adolescent Psychiatry (JAACAP) is the official publication of the American Academy of Child and Adolescent Psychiatry. JAACAP is the leading journal focusing exclusively on today's psychiatric research and treatment of the child and adolescent. Published twelve times per year, each issue is committed to its mission of advancing the science of pediatric mental health and promoting the care of youth and their families.
The Journal's purpose is to advance research, clinical practice, and theory in child and adolescent psychiatry. It is interested in manuscripts from diverse viewpoints, including genetic, epidemiological, neurobiological, cognitive, behavioral, psychodynamic, social, cultural, and economic. Studies of diagnostic reliability and validity, psychotherapeutic and psychopharmacological treatment efficacy, and mental health services effectiveness are encouraged. The Journal also seeks to promote the well-being of children and families by publishing scholarly papers on such subjects as health policy, legislation, advocacy, culture and society, and service provision as they pertain to the mental health of children and families. www.jaacap.org
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