HOARDING SYMPTOMS IN PATIENTS ON A GERIATRIC PSYCHIATRY INPATIENT UNIT

Background, While collecting may be a normal behaviour, hoarding is a symptom of various psychiatric disorders, including obsessive-compulsi ve disorder (OCD) and obsessive-compulsive personality disorder (OCPD) . Although anecdotal reports suggest that hoarding is not uncommon in geriatric psychiatry populations, its psychopathological correlates in such samples have not been well characterised. Methods. The presence of clinically significant hoarding symptoms was screened for in 100 co nsecutive patients in a geriatric psychiatry inpatient unit, Both pati ent and collateral histories were obtained, When hoarding symptoms wer e present, a detailed history of their phenomenology was obtained by m eans of a structured questionnaire and the response of hoarding sympto ms to treatment during hospitalisation was monitored. Results. Clinica lly significant hoarding was found in 5/100 subjects. Four of these 5 patients met DSM-IV criteria for schizophrenia (paranoid subtype), wit h onset of symptoms coinciding with increased symptoms of dementia. Th e fifth patient met criteria for bipolar disorder (manic episode), als o had symptoms of dementia, and had a lifelong history of hoarding. Ho arding behaviours responded to antipsychotic treatment in 3 of the 5 p atients. Conclusions. A history of hoarding may be useful in many psyc hiatric patients, but psychopathological correlates of this symptom ar e likely to vary with age, In a geriatric psychiatry inpatient populat ion hoarding was associated not with OCD or OCPD, but rather with para noid schizophrenia and increasing symptoms of dementia. Dopamine block ers appeared useful in decreasing hoarding in some patients, raising i nteresting questions about the neurobiology of this symptom.