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Testing the validity and acceptability of the diagnostic criteria for Hoarding Disorder: a DSM-5 survey

Published online by Cambridge University Press:  13 May 2011

D. Mataix-Cols ,
L.. Fernández de la Cruz ,
T. Nakao  and
A. Pertusa
D. Mataix-Cols*
Affiliation:
King's College London, Institute of Psychiatry, London, UK
L.. Fernández de la Cruz
Affiliation:
King's College London, Institute of Psychiatry, London, UK
T. Nakao
Affiliation:
King's College London, Institute of Psychiatry, London, UK
*
*Address for correspondence: D. Mataix-Cols, Ph.D., Departments of Psychosis Studies and Psychology, King's College London, Institute of Psychiatry, PO Box 69, De Crespigny Park, London SE5 8AF, UK. (Email: [email protected])
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Abstract

Background

The DSM-5 Obsessive-Compulsive Spectrum Sub-Workgroup is recommending the creation of a new diagnostic category named Hoarding Disorder (HD). The validity and acceptability of the proposed diagnostic criteria have yet to be formally tested.

Method

Obsessive-compulsive disorder/hoarding experts and random members of the American Psychiatric Association (APA) were shown eight brief clinical vignettes (four cases meeting criteria for HD, three with hoarding behaviour secondary to other mental disorders, and one with subclinical hoarding behaviour) and asked to decide the most appropriate diagnosis in each case. Participants were also asked about the perceived acceptability of the criteria and whether they supported the inclusion of HD in the main manual.

Results

Altogether, 211 experts and 48 APA members completed the survey (30% and 10% response rates, respectively). The sensitivity and specificity of the HD diagnosis and the individual criteria were high (80–90%) across various types of professionals, irrespective of their experience with hoarding cases. About 90% of participants in both samples thought the criteria would be very/somewhat acceptable for professionals and sufferers. Most experts (70%) supported the inclusion of HD in the main manual, whereas only 50% of the APA members did.

Conclusions

The proposed criteria for HD have high sensitivity and specificity. The criteria are also deemed acceptable for professionals and sufferers alike. Training of professionals and the development and validation of semi-structured diagnostic instruments should improve diagnostic accuracy even further. A field trial is now needed to confirm these encouraging findings with real patients in real clinical settings.

Keywords

DiagnosisDSM-5Hoarding DisorderOCD
Type
Original Articles
Information
Psychological Medicine , Volume 41 , Issue 12 , December 2011 , pp. 2475 - 2484
Copyright
Copyright © Cambridge University Press 2011

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References

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