Pharmacotherapy for the Treatment of Hoarding Disorder

Hoarding disorder, which is characterized by difficulty discarding or parting with possessions, is common and potentially “disabling.” In fact, this behavior usually has some harmful effects, such as emotional, physical, social, financial, and even legal implications. Also, people who hoard often exhibit irrational behavior.

In some studies, hoarding has been listed as diagnostic criteria for obsessive-compulsive personality disorder (OCPD); however, some consider hoarding a disorder in itself. There are various routes of treatment for hoarding disorder, including both psychotherapy and pharmacotherapy. For the purpose of this assignment, I will focus more on the pharmacotherapy.

Since hoarding disorder is closely associated with OCD, pharmacotherapy for the treatment of hoarding disorder is similar to treatment of OCD. Studies have shown that OCD patients respond well to the use of selective serotonin reuptake inhibtors (SSRI’s), and some of these drugs have clinical effect in patients with hoarding behavior/disorder. In one study done by Sanjaya Saxena, it was concluded that the use of paroxetine (Paxil), which is an SSRI, improved hoarding symptoms, depression, and anxiety. Furthermore, venlafaxine has also shown good response with hoarding behaviors. In fact, venlafaxine had a trend for greater reduction in hoarding symptoms than that seen with paroxetine. New treatment strategies might also include cognitive enhancers, such as donepezil, to increase attention and executive functioning in patients with hoarding disorder.

In conclusion, hoarding disorder is a common and relevant problem that can tremendously affect someone’s life, but can be treated. Hoarding disorder, along with its signs and symptoms, can be improved by pharmacologic therapy (mostly the use of SSRI’s), psychological therapy, or a combination of both.

 

http://www.uspharmacist.com/content/d/pharmacy_focus/c/58008/

Saljoughian, Manouchehr. Hoarding Disorder: Diagnosis and Treatment. US Pharm. 2015:40(11):60-62.

Increased Risk of Mortality in Patients Diagnosed with Obsessive-Compulsive Disorder

Obsessive-Compulsive Disorder (OCD) is a mental disorder that is characterized by intrusive thoughts or feelings which are accompanied by certain behaviors in attempt to relieve anxiety. This disorder is very debilitating, so researchers in Denmark set out to find if a diagnosis with OCD had an increased risk of mortality. This prospective cohort study looked at people born in Denmark between January 1, 1955 and November 31, 2006. The study included 3,270,650 people. Of the total population being studied, 10,155 people were diagnosed with OCD. The maximum age for any the cohort member was 57, because the researchers didn’t want to include older adults due to higher instances of mortality among that population. The researchers utilized a “follow-up” period, which began at January 1, 2002 and ended when the subjects either died, moved out of Denmark, or on December 31, 2011. The causes of death were placed into certain categories, such as deaths from physical conditions, deaths from external causes, and deaths from unnatural causes.

During the study follow-up period, 27,236 people died. Of these deaths, 110 of them were people who were diagnosed with OCD. The study also took into account how many of those people had received a comorbid diagnosis of another mental disorder; 82 of the 110 deaths were people with comorbid diagnosis. The results of the study concluded that people with diagnosed OCD had an increased risk of premature death in comparison to people that were not diagnosed with the disorder. Of these deaths, 40% of them were a result of unnatural causes, such as suicides, homicides, or accidents. Additionally, since 82 of the 110 deaths were people with comorbid mental disorder, the study suggests that comorbidity has a strong influence on mortality in people diagnosed with OCD.

I didn’t think the results of this study were very surprising, because the study starts out by saying that there are a number of mental disorders that are associated with an increased rate of mortality. OCD is considered to be one of the most debilitating mental disorders, so it comes as no surprise that it would have an effect on one’s life expectancy. Also, I think this article demonstrates the importance of increasing the awareness of mental illness. If caught early, sufferers of OCD have a better chance of living a more normal, functional life. On the other hand, the longer the disorder persists without treatment, the more debilitating the disorder ends up being. Therefore, consideration should be given to promoting the importance of mental health so that patients could have a increased chance of getting the proper treatment and medication for their disorder.

Meier SM, Mattheisen M, Mors O, et al. Mortality Among Persons With Obsessive-Compulsive Disorder in Denmark. JAMA Psychiatry. doi:10.1001/jamapsychiatry.2015.3105. (Published 27 January 2016).