The profile of executive function in OCD hoarders and hoarding disorder

Sharon Morein-Zamir; Martina Papmeyer; Alberto Pertusa; Samuel R Chamberlain; Naomi A Fineberg; Barbara J Sahakian; David Mataix-Cols; Trevor W Robbins

doi:10.1016/j.psychres.2013.12.026

The profile of executive function in OCD hoarders and hoarding disorder

Psychiatry Res. 2014 Mar 30;215(3):659-67. doi: 10.1016/j.psychres.2013.12.026. Epub 2013 Dec 21.

Authors

Sharon Morein-Zamir¹, Martina Papmeyer², Alberto Pertusa³, Samuel R Chamberlain⁴, Naomi A Fineberg⁵, Barbara J Sahakian⁴, David Mataix-Cols⁶, Trevor W Robbins²

Affiliations

¹ Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, UK; Department of Psychiatry, University of Cambridge, Cambridge, UK; Department of Psychology, University of Cambridge, Cambridge, UK. Electronic address: sm658@cam.ac.uk.
² Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, UK; Department of Psychology, University of Cambridge, Cambridge, UK.
³ Departments of Psychology and Psychosis Studies, King's College London, Institute of Psychiatry, London, UK.
⁴ Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, UK; Department of Psychiatry, University of Cambridge, Cambridge, UK.
⁵ Mental Health Unit, QEII Hospital, Welwyn Garden City, Hertfordshire, UK.
⁶ Department of Psychology, University of Cambridge, Cambridge, UK; Departments of Psychology and Psychosis Studies, King's College London, Institute of Psychiatry, London, UK.

Abstract

Hoarding disorder is a new mental disorder in DSM-5. It is classified alongside OCD and other presumably related disorders in the Obsessive-Compulsive and Related Disorders chapter. We examined cognitive performance in two distinct groups comprising individuals with both OCD and severe hoarding, and individuals with hoarding disorder without comorbid OCD. Participants completed executive function tasks assessing inhibitory control, cognitive flexibility, spatial planning, probabilistic learning and reversal and decision making. Compared to a matched healthy control group, OCD hoarders showed significantly worse performance on measures of response inhibition, set shifting, spatial planning, probabilistic learning and reversal, with intact decision making. Despite having a strikingly different clinical presentation, individuals with only hoarding disorder did not differ significantly from OCD hoarders on any cognitive measure suggesting the two hoarding groups have a similar pattern of cognitive difficulties. Tests of cognitive flexibility were least similar across the groups, but differences were small and potentially reflected subtle variation in underlying brain pathology together with psychometric limitations. These results highlight both commonalities and potential differences between OCD and hoarding disorder, and together with other lines of evidence, support the inclusion of the new disorder within the new Obsessive-Compulsive and Related Disorders chapter in DSM-5.

Keywords: Cognition; Hoarding; Hoarding disorder; Obsessive compulsive disorder (OCD).

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adult
Case-Control Studies
Cognition / physiology
Comorbidity
Compulsive Behavior
Decision Making / physiology*
Executive Function / physiology*
Female
Hoarding Disorder / diagnosis*
Hoarding Disorder / epidemiology
Hoarding Disorder / psychology
Humans
Inhibition, Psychological
Male
Obsessive-Compulsive Disorder / diagnosis*
Obsessive-Compulsive Disorder / epidemiology
Obsessive-Compulsive Disorder / psychology
Psychiatric Status Rating Scales
Psychometrics

Abstract

Publication types

MeSH terms

Grants and funding