Commentary on Compulsive Hoarding Associated with Abortion

The authors report a case of an adolescent onset of obsessive compulsive (OC) and depressive symptoms following medical termination of pregnancy at 9 weeks gestation. In addition, the authors describe successful implementation of standardized, evidence based multimodal treatment approaches. OC symptom severity and treatment responses were monitored by serial administration of the Children’s Yale Brown Obsessive-Compulsive scale (CY-BOCS), a widely used clinical instrument. Finally, the discussion section includes a brief review of what is currently known about the association of female reproductive events and the onset of OC symptoms.

This case highlights the complex task of understanding the relationship between clinical symptoms, etiology and physiology of OC symptoms. For example, the authors report that compulsive hoarding (CH) was the main presenting OC symptom. CH is now recognized as an important symptom dimension of Obsessive compulsive disorder (OCD) [1]. However, patients with CH may have distinct brain activation patterns, sociodemographic and clinical features. A recent functional magnetic resonance imaging study suggested that, compared with checking and washing behaviours, CH predominantly activated ventral prefrontal regions and the left amygdale [2]. Furthermore, patients with CH have a younger age of onset and higher co-morbidity rates of bipolar II and eating disorders [3]. Indeed, the possible association of CH and eating disorders may be of particular relevance for the present case report. Previous animal studies have reported an association of food hoarding (storage of food beyond immediate energy requirements) with pregnancy and lactation [4]. Thus, the present case report successfully raises the issue of studying physiological correlates of specific OCD symptoms during childhood and adolescence.