Hoarding Symptoms in Children and Adolescents with Obsessive-Compulsive Disorder: Clinical Features and Response to Cognitive-Behavioral Therapy

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College of Arts Humanities and Social Sciences, Psychology


Pediatric, Obsessive-compulsive disorder (OCD), Hoarding



Although adult hoarding disorder is relatively common and often debilitating, few studies have examined the phenomenology of pediatric hoarding. We examined the clinical phenomenology and response to cognitive-behavioral therapy (CBT) treatment in youths with a diagnosis of obsessive-compulsive disorder (OCD) with and without hoarding symptoms. Age was tested as a moderator across analyses, given prior findings that the impact of hoarding symptoms may not become apparent until adolescence.


Youths (N = 215; aged 7−17 years) with OCD pursuing evaluation and/or treatment at a university-based specialty clinic participated in the current study. Presence of hoarding symptoms was assessed as part of a larger battery. Data from a subset of youths (n = 134) who received CBT were included in treatment response analyses.


Youths with hoarding symptoms did not differ from those without hoarding symptoms with respect to overall OCD symptom severity and impairment. Youths with hoarding met criteria for more concurrent diagnoses, including greater rates of internalizing and both internalizing/externalizing, but not externalizing-only, disorders. Youths with and without hoarding symptoms did not significantly differ in rate of response to CBT. Age did not moderate any of these relationships, suggesting that the presence of hoarding symptoms was not associated with greater impairments across the clinical presentation of OCD or its response to treatment by age.


We found no evidence that hoarding is associated with greater OCD severity or poorer treatment response in affected youth. Theoretical and clinical implications of these findings, including future directions for research on testing developmental models of hoarding across the lifespan, are discussed.

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Copyright is held by the American Academy of Child and Adolescent Psychiatry. User is responsible for all copyright compliance. This article was originally published as:

Rozenman, M., McGuire, J., Wu, M., Ricketts, E., Peris, T., O’Neill, J., ..., & Piacentini, J. (2019). Hoarding symptoms in children and adolescents with obsessive-compulsive disorder: Clinical features and response to cognitive-behavioral therapy. Journal of the American Academy of Child and Adolescent Psychiatry, 58(8), 799-805. https://doi.org/10.1016/j.jaac.2019.01.017

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American Academy of Child and Adolescent Psychiatry


Received from CHORUS


English (eng)

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Journal of the American Academy of Child and Adolescent Psychiatry





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