Schizophrenia and Hoarding Disorder
It’s not uncommon for people with schizophrenia to also have symptoms of an obsessive-compulsive disorder. These might involve repetitive thoughts or behaviors that the person views as excessive or unreasonable but can’t seem to stop.
One example is hoarding disorder. Although it’s not often discussed openly, hoarding—excessively saving random items and being unable to get rid of them—is a very real issue. In fact, it’s a problem that occurs in up to 5% of the American population.
If you know someone who has schizophrenia, he or she may be at greater risk for hoarding disorder. Find out how to help a loved one with schizophrenia who might have hoarding problems.
People who hoard save things that are of seemingly no value to others. These may include clothes, books, old newspapers, even food wrappers and packing materials. They feel extreme stress at the idea of getting rid of the items.
Hoarding can lead to a buildup of clutter that can greatly impact people’s lives and cause social isolation. Hoarders may not be able to use all their living space because it’s filled with things. And the clutter can create an unsafe, unhealthy place to live.
The Schizophrenia Connection
Although hoarding is now considered a disorder of its own, it’s long been thought of as only a symptom of obsessive-compulsive disorder. It’s estimated that about 25% of people with schizophrenia also struggle with some kind of obsessive-compulsive symptom. Experts aren’t sure exactly why many people with schizophrenia also have obsessive-compulsive tendencies. But the two conditions begin around the same time in life, and both are thought to occur in certain pathways in the brain.
People with schizophrenia may hoard things because of delusional beliefs. Also, although many people who take antipsychotic drugs never show signs of hoarding or other obsessive-compulsive symptoms, some experts believe that one specific antipsychotic medication, clozapine, can aggravate or even trigger the problem in certain people with schizophrenia. The other antipsychotics generally improve obsessive-compulsive symptoms. Clozapine is often prescribed to patients who fail to respond to these other drugs and are at-risk for self-injurious behavior.
Impact on Illness
Whatever the cause of the hoarding, it can have a major effect on your loved one’s life and complicate his or her treatment. Research shows that people with schizophrenia who have hoarding problems or other obsessive-compulsive symptoms fare worse than those with schizophrenia who don’t. Those with obsessive-compulsive symptoms have more severe psychosis, increased risk for depression, less ability to relate to others, greater memory problems, and a lower likelihood of finding a job.
To help your loved one have the best, most productive life possible, it’s important to help him or her get treatment. The two major treatment options for hoarding and other obsessive-compulsive symptoms are cognitive behavioral therapy and medicine.
Hope Through Treatment
Cognitive behavioral therapy is a type of counseling that helps people learn how to overcome hoarding symptoms and live a more productive life. This may include slowly breaking those thoughts and habits that lead to the excessive collecting. It may also include developing problem-solving skills and improving the ability to relax.
Because ongoing delusions or clozapine treatment may play a part in obsessive-compulsive symptoms such as hoarding, it’s important to diagnose the condition correctly. With a clear diagnosis, your loved one’s doctor can create a treatment plan that addresses the relevant problems. For example, your loved one’s antipsychotic medication may be tailored to reduce obsessive-compulsive symptoms. The doctor may also prescribe anti-depressant medications, which may help reduce hoarding tendencies.
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- Comorbid obsessive-compulsive symptoms in schizophrenia: contributions of pharmacological and genetic factors. F. Schirmbeck and M. Zink. Frontiers in Pharmacology. 2013, vol. 4, pp. 99.
- Nonclinical Obsessive-Compulsive Symptoms and Executive Functions in Schizophrenia. S. Kumbhani et al. The Journal of Neuropsychiatry and Clinical Neurosciences, Vol. 22, No. 3.
- Schizophrenia and Obsessive-Compulsive Disorder. D Calin. Revista Romana de Psihiatria Copilului si Adolescentului. December 2011, vol. 5, no. 3-4, pp. 27-32.