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Hoarding power point presentation

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  • 1. By Dr.Shewikar El Bakry
  • 2.  Hoarding is defined as the acquisition of, and inability to discard, worthless items even though they appear (to others) to have no value.  Hoarding and saving behavior has been observed in several neuropsychiatric disorders, including schizophrenia, dementia, eating disorders, autism, and mental retardation , as well as in nonclinical populations , but it is most commonly found in patients with OCD.
  • 3.  1- The hoarders show a unique pattern of Brain activity.  2- Don't respond well - if at all - to standard anti-obsessional treatments.(drugs and CBT).  3- Hoarders do not come forward for treatment.  4- Hoarders tend to believe they are acting rationally and have less insight to the problem.  5- hoarders had more severe family and social disability, anxiety, depression, and personality disorder symptoms
  • 4. Large-scale factor and cluster analytic studies of OCD have identified four principal symptom factors: 1) aggressive, sexual, and religious obsessions with checking compulsions; 2) symmetry obsessions with ordering, arranging, and repeating compulsions; 3) contamination obsessions with washing and cleaning compulsions; 4) hoarding, saving, and collecting symptoms.
  • 5. 1-Frost and colleagues have argued persuasively that hoarding and saving symptoms are part of a discrete clinical syndrome that also includes indecisiveness, perfectionism, procr astination, difficulty organizing tasks, and avoidance
  • 6.  2-Compulsive hoarding is most commonly driven by obsessional fears of losing important items that the patient believes will be needed later, distorted beliefs about the importance of possessions, and excessive emotional attachments to possessions
  • 7.  3-Hoarders usually fear making "wrong decisions" about what to discard and what to keep, so they acquire and save items to prepare for every imaginable contingency.  4-The most commonly saved items include newspapers, magazines, old clothing, bags, books, mail, notes, and lists.
  • 8.  5-Living spaces become sufficiently cluttered to preclude the activities for which they were designed, causing significant impairment in social and/or occupational functioning associated with poor response to medications and cognitive behavior therapy.
  • 9.  6- Reluctance or inability to return borrowed items. As boundaries blur, impulsive acquisitiveness could sometimes lead to kleptomania or stealing.  7- A survey of elderly hoarders found that hoarding constituted a physical health threat to 81% of identified patients, including the threat of fire hazard, falling, unsanitary conditions, and an inability to prepare food.
  • 10. Book hoarding Bibliomania is an obsessive-compulsive disorder involving the collecting or hoarding of books to the point where social relations or health are damaged. Animal hoarding Animal hoarding involves keeping higher than usual numbers of animals as pets without having the ability to properly house or care for them, while at the same time denying this inability.
  • 11.  higher rates of hoarding and tics in the first- degree relatives .  Compulsive hoarding also has a different pattern of genetic inheritance than other OCD symptom factors. The hoarding/saving symptom factor has a recessive inheritance pattern, whereas the aggressive/checking and symmetry/order symptom factors show a dominant pattern .  A genome-wide scan conducted in sibling pairs with Gilles de la Tourette’s syndrome found that the hoarding phenotype was significantly associated with genetic markers on chromosomes 4q34-35, 5q35.2-35.3, and 17q25
  • 12. In relation to comparison subjects, compulsive hoarders had significantly lower cerebral glucose metabolism in the right posterior cingulate gyrus
  • 13. In relation to comparison subjects, compulsive hoarders had significantly higher metabolism in the left dorsolateral prefrontal cortex
  • 14. In relation to comparison subjects, nonh oarding OCD patients had significantly higher glucose metabolism in the left thalamus
  • 15. In relation to nonhoarding OCD patients, compulsive hoarders had significantly lower regional cerebral glucose metabolism in the dorsal anterior cingulate gyrus
  • 16. Medications for Compulsive Hoarding The compulsive-hoarding syndrome has often proven refractory to these standard medications for OCD. Cognitive-Behavioral Therapy (CBT) for Compulsive Hoarding CBT for compulsive hoarding is directed towards decreasing clutter, improving decision- making skills, and improving organizational/ sorting techniques.
  • 17. Behind Closed Doors: The Horrors of Animal Hoarding By Rebe cca Sim mon s To some one desp erate to find a hom e for a litter of kitte ns, the Chu bbers Ani mal Resc ue woul d have appe ared to be the perfe ct have n. Nestl ed in a woo ded lot in Caro line Cou nty, Mar ylan d, the form er