Biriktirme Bozukluğunda Bilişsel Davranışçı Terapi: Sistematik bir Gözden Geçirme

Biriktirme bozukluğu önceleri obsesif-kompulsif bozukluğun bir türü olarak değerlendirilmesine rağmen, son yıllarda bulunan bazı farklılıklar biriktirmenin DSM-5’te obsesif-kompulsif bozukluk ve ilişkili bozukluklar altında ayrı bir bozukluk olarak yeniden sınıflandırılmasını sağlamıştır. Biriktirme bozukluğu olan hastalar eşyalarını elden çıkarmaya ilişkin yoğun korku gibi güçlü olumsuz duygular yaşar ve sahip oldukları şeylerin önemini abartırlar. Biriktirme bozukluğu için bireysel, grup ve kendine yardım tedavilerini içeren farklı bilişsel davranışçı terapi protokolleri olduğu görülmektedir. Bu çalışmada biriktirme bozukluğu tedavisinde uygulanan bilişsel davranışçı terapinin etkililiğini değerlendirmek için yapılmış ampirik çalışmaların gözden geçirilmesi amaçlanmıştır. Ölçütleri karşılayan 12 çalışmanın yöntem ve terapi özellikleri karşılaştırılarak sunulmuştur. Biriktirme bozukluğu olan kişilere uygulanan bilişsel davranışçı terapilerin, bozukluğa ilişkin belirtileri ve/veya bozukluğa eşlik eden sorunları (depresyon, anksiyete vb.) azaltmada etkili olduğu görülmektedir.

Cognitive Behavioral Therapy for Hoarding Disorder: A Systematic Review

Although hoarding has been considered as a type of obsessive-compulsive disorder before, some differences that were found lead to reclassify hoarding as a separate disorder under obsessive-compulsive disorder and related disorders in DSM-5. Patients with hoarding disorder have negative feelings like strong fear when considering getting rid of items and exaggerate the importance of possessions. Different cognitive behavioral therapy protocols including individual, group and self-help treatments are used for treating hoarding disorder. The aim of this study is to review empirical studies that were carried out to evaluate the effectiveness of cognitive behavioral therapy for the treatment of hoarding disorder. The 12 studies fitting the search criteria were included in this review and were summarized in terms of their methods used and their therapy characteristic. The studies included in this review suggested that cognitive behavioral therapy for hoarding disorder is effective in decreasing the symptoms of the disorder and/or the accompanying problems like depression and anxiety.

___

  • American Psychiatric Association (2013) Diagnostic and statistical manual of mental disorders, 5th ed. Arlington, American Psychiatric Publishing.
  • Ayers CR, Espejo EP (2011) Helping patients with compulsive hoarding. J Clin Outcomes Manag, 18: 326-333.
  • Ayers CR, Wetherell JL, Golshan S, Saxena S (2011) Cognitive-behavioral therapy for geriatric compulsive hoarding. Behav Res Ther, 49: 689-694.
  • Franklin ME, Abramowitz JS, Kozak MJ, Levitt JT, Foa EB (2000) Effectiveness of exposure and ritual prevention for obsessive-compulsive disorder: randomized compared with nonrandomized samples. J Consult Clin Psychol, 68: 594-602.
  • Frost RO, Hartl TL (1996) A cognitive-behavioral model of compulsive hoarding. Behav Res Ther, 34: 341-350.
  • Frost RO, Steketee G, Tolin DF (2012) Diagnosis and assessment of hoarding disorder. Annu Rev Clin Psychol, 8: 219-242.
  • Frost RO, Steketee G, Williams L (2000) Hoarding: a community health problem. Health Soc Care Community, 8: 229-234.
  • Gilliam CM, Norberg MM, Villavicencio A, Morrison S, Hannan SE, Tolin DF (2011) Group cognitive-behavioral therapy for hoarding disorder: an open trial. Behav Res Ther, 49: 802-807.
  • Ivanov VZ, Enander J, Mataix‐Cols D, Serlachius E, Mansson KN, Andersson G et al. (2018) Enhancing group cognitive‐behavioral therapy for hoarding disorder with between‐session internet‐based clinician support: a feasibility study. J Clin Psychol, 74: 1092-1105.
  • Kellett S, Matuozzo H, Kotecha C (2015) Effectiveness of cognitive-behaviour therapy for hoarding disorder in people with mild intellectual disabilities. Res Dev Disabil, 47: 385-392.
  • Levy HC, Worden BL, Gilliam CM, D’Urso C, Steketee G, Frost RO et al. (2017) Changes in saving cognitions mediate hoarding symptom change in cognitive-behavioral therapy for hoarding disorder. J Obsessive Compuls Relat Disord, 14: 112-118.
  • Moulding R, Nedeljkovic M, Kyrios M, Osborne D, Mogan C (2017) Short‐term cognitive–behavioural group treatment for hoarding disorder: a naturalistic treatment outcome study. Clin Psychol Psychother, 24: 235-244.
  • Muroff J, Steketee G, Rasmussen J, Gibson A, Bratiotis C, Sorrentino C (2009) Group cognitive and behavioral treatment for compulsive hoarding: a preliminary trial. Depress Anxiety, 26: 634-640.
  • Muroff J, Steketee G, Bratiotis C, Ross A (2012) Group cognitive and behavioral therapy and bibliotherapy for hoarding: a pilot trial. Depress Anxiety, 29: 597-604.
  • Muroff J, Steketee G, Frost RO, Tolin DF (2014) Cognitive behavior therapy for hoarding disorder: follow‐up findings and predictors of outcome. Depress Anxiety, 31: 964-971.
  • Pollock L, Kellett S, Totterdell P (2014) An intensive time-series evaluation of the effectiveness of cognitive behaviour therapy for hoarding disorder: a 2-year prospective study. Psychother Res, 24: 485-495.
  • Saxena S, Ayers CR, Maidment KM, Vapnik T, Wetherell JL, Bystritsky A (2011) Quality of life and functional impairment in compulsive hoarding. J Psychiatr Res, 45: 475-480.
  • Saxena S, Brody AL, Maidment KM, Baxter Jr LR (2007) Paroxetine treatment of compulsive hoarding. J Psychiatr Res, 41: 481-487.
  • Saxena S, Sumner J (2014) Venlafaxine extended-release treatment of hoarding disorder. Int Clin Psychopharmacol, 29: 266-273.
  • Steketee G, Frost RO, Tolin DF, Rasmussen J, Brown TA (2010) Waitlist‐controlled trial of cognitive behavior therapy for hoarding disorder. Depress Anxiety, 27: 476-484.
  • Thompson C, de la Cruz LF, Mataix-Cols D, Onwumere J (2017) A systematic review and quality assessment of psychological, pharmacological, and family-based interventions for hoarding disorder. Asian J Psychiatr, 27: 53-66.
  • Tolin DF, Frost RO, Steketee G, Muroff J (2015) Cognitive behavioral therapy for hoarding disorder: a meta‐analysis. Depress Anxiety, 32: 158-166.
  • Williams M, Viscusi JA (2016) Hoarding disorder and a systematic review of treatment with cognitive behavioral therapy. Cogn Behav Ther, 45: 93-110.
  • Worden BL, Bowe WM, Tolin DF (2017) An open trial of cognitive behavioral therapy with contingency management for hoarding disorder. J Obsessive Compuls Relat Disord, 12: 78-86.