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Hoarders' Brains Overwhelmed by Decisions

Imaging Study Points to Disorder Distinct From Obsessive-Compulsive Disorder
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Hoarding Distinct From OCD

The other participants in the study showed no such reaction to the decision-making process. Although that may not be surprising for the healthy group, it is a telling detail regarding OCD. Tolin says that until recently, hoarding has been considered a component or sub-type of OCD. The fact that different brain regions are at play in the two groups is evidence that the two disorders are distinct.

Psychiatrist Sanjaya Saxena, MD, who has also published imaging studies of hoarders' brains, says that Tolin's work is important.

"This is the largest brain-imaging study of hoarders, and it's rare to get papers like this where you have such a large group," says Saxena, who directs the OCD Clinic at the University of California, San Diego. "There have only been a handful of such studies, but the results are beginning to converge."

Saxena estimates that 3% to 5% of the population has hoarding disorder. "Hoarding is much more common than OCD, and it is a very understudied disorder," says Saxena, who reviewed the study for WebMD.

"The takeaway from this study is that more and more data show that hoarding is a separate disorder and needs to be treated as such," says Travis Osborne, PhD, a clinical psychologist at Evidence Based Treatment Centers in Seattle.

Osborne, who was not involved in the research, sees many hoarders in his practice. Treating them, he says, is a real challenge.

"People who hoard get stuck because of problems with decision making," he says. "To clean out their homes means making thousands or tens of thousands of decisions about what to throw away. They have to decide about every single piece of paper. This study of decision-making lends concrete support to what we see clinically."

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