August 6, 2012

expert reaction to ‘neural mechanisms of decision making in hoarding disorder’

Patients with hoarding disorder exhibited abnormal activity in regions of the brain, according to a report in the Archives of General Psychiatry.

Prof David Mataix-Cols, from the Institute of Psychiatry, King’s College London, Advisor to the DSM-5 Obsessive-Compulsive and Related Disorders workgroup, said:

“The difficulty to discard possessions, even those of little apparent value, is one of the landmark features of the newly proposed Hoarding Disorder. Decision-making difficulties are thought to contribute to the inability to discard possessions. The study by Tolin et al 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 include a new diagnostic category in DSM-5 and 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. Studies that tap into those causal mechanisms are sorely needed.”

‘Neural Mechanisms of Decision Making in Hoarding Disorder’ by Tolin, et al., published in