European Child & Adolescent Psychiatry

, Volume 28, Issue 8, pp 1097–1106 | Cite as

Hoarding in children and adolescents with obsessive–compulsive disorder: prevalence, clinical correlates, and cognitive behavioral therapy outcome

  • Davíð R. M. A. HøjgaardEmail author
  • Gudmundur Skarphedinsson
  • Tord Ivarsson
  • Bernhard Weidle
  • Judith Becker Nissen
  • Katja A. Hybel
  • Nor Christian Torp
  • Karin Melin
  • Per Hove Thomsen
Original Contribution


Hoarding, common in pediatric obsessive–compulsive disorder (OCD), has specific clinical correlates and is associated with poor prognosis. However, there are few studies of hoarding in pediatric OCD. This study estimates the occurrence of hoarding symptoms in a sample of children and adolescents with OCD, investigating possible differences in demographic and clinical variables between pediatric OCD with and without hoarding symptoms. Furthermore, the study investigates whether hoarding symptoms predict poorer treatment outcomes after cognitive behavioral therapy (CBT). The study sample comprised 269 children and adolescents with OCD, aged 7–17 years, from Denmark, Sweden, and Norway, who were all included in the Nordic long-term obsessive–compulsive disorder Treatment Study. All had an OCD diagnosis according to the DSM-IV and were treated with 14 weekly sessions of manualized, exposure-based CBT. Hoarding symptoms and OCD severity were assessed with the Children’s Yale–Brown Obsessive–Compulsive Scale and group differences in treatment outcome were analyzed using linear mixed-effect modelling. Seventy-two patients (26.8%) had one or more symptoms of hoarding. Comorbid tic disorders (p = 0.005) and indecision (p = 0.024) were more prevalent among those with hoarding symptoms than those without hoarding symptoms. In addition, youth with hoarding symptoms had a different OCD symptom profile. Having symptoms of hoarding did not affect CBT outcome (p = 0.933). Results from the study suggest that CBT is equally effective for those with and without hoarding-related OCD.


Obsessive-compulsive disorder Hoarding Cognitive behavioral therapy Treatment Pediatric NordLOTS 



The authors would like to thank TrygFonden, Lundbeck Foundation and Central Region Denmark’s Research Fund for supporting the research presented in this article through project Grants.

Compliance with ethical standards

Conflict of interest

Dr. Ivarsson has served on the speaker’s bureau of Shire Sweden. All remaining authors report no biomedical financial interests or potential conflicts of interest.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  • Davíð R. M. A. Højgaard
    • 1
    Email author
  • Gudmundur Skarphedinsson
    • 2
  • Tord Ivarsson
    • 3
  • Bernhard Weidle
    • 4
  • Judith Becker Nissen
    • 1
  • Katja A. Hybel
    • 1
  • Nor Christian Torp
    • 5
  • Karin Melin
    • 6
  • Per Hove Thomsen
    • 1
    • 4
  1. 1.Department of Child and Adolescent PsychiatryAarhus University Hospital PsychiatryÅrhusDenmark
  2. 2.Faculty of PsychologyUniversity of IcelandReykjavíkIceland
  3. 3.The Center for Child and Adolescent Mental Health. Eastern and Southern Norway (RBUP)OsloNorway
  4. 4.Regional Center for Child and Youth Mental HealthNorwegian University of Science and TechnologyTrondheimNorway
  5. 5.Division of Mental Health and Addiction, Department of Child and Adolescent PsychiatryVestre Viken HospitalDrammenNorway
  6. 6.Department of Child and Adolescent PsychiatryQueen Silvia Children’s Hospital, Sahlgrenska University HospitalGöteborgSweden

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