Hoarding behavior among young children with obsessive–compulsive disorder

• In a sample of young children with OCD, nearly half exhibited hoarding symptoms.
• Children with OCD and hoarding symptoms had a higher proportion of comorbid ADHD than children with OCD and no hoarding symptoms.
• Children with hoarding symptoms had an earlier age of primary diagnosis onset than children without hoarding symptoms.

Previous research has shown that among the various subtypes of obsessive–compulsive disorder (OCD), adults (e.g. Frost, Krause, & Steketee, 1996) and older children and adolescents (Bloch et al., 2009; Storch et al., 2007) with problematic hoarding have distinct features and a poor treatment prognosis. However, there is limited information on the phenomenology and prevalence of hoarding behaviors in young children. The present study characterizes children ages 10 and under who present with OCD and hoarding behaviors.Sixty-eight children received a structured interview-determined diagnosis of OCD. Clinician administered, parent-report, and child-report measures on demographic, symptomatic, and diagnostic variables were completed. Clinician ratings of hoarding symptoms and parent and child endorsement of the hoarding item on the Children's Yale-Brown Obsessive Compulsive Scale (CY-BOCS) checklist (Scahill, Riddle, McSwaggin-Hardin, & Ort, 1997) determined inclusion in the hoarding group (n=33).Compared to children without hoarding symptoms (n=35), the presence of hoarding symptoms was associated with an earlier age of primary diagnosis onset and a higher proportion of ADHD and provisional anxiety diagnoses. These results are partially consistent with the adult literature and with findings in older children ( Storch et al., 2007). Additional data on clinical presentation and phenomenology of hoarding are needed to form a developmentally appropriate definition of the behavior.