RESUMO
Animal hoarding disorder (AHD) is classified as a psychiatric obsessive-compulsive condition characterized by animal accumulation and often accompanied by unsanitary conditions and animal cruelty. Although AHD may increase pathogen transmission and spread, particularly for zoonotic diseases, human and dog exposure in such cases has yet to be fully established. Accordingly, this study aimed to assess Brucella canis in 19 individuals with AHD (11 households) and their 264 dogs (21 households) in Curitiba, the eighth largest city in Brazil, with approximately 1.8 million habitants. Anti-B. canis antibodies were detected by the 2-mercaptoethanol microplate agglutination test (2ME-MAT) and by a commercial lateral flow immunoassay (LFIA), while molecular detection of previously positive seropositive samples was performed by conventional PCR. Although all the human samples were 2ME-MAT negative, 12/264 (4.5%, 95% Confidence Interval: 2.0-7.0%) dog samples were 2ME-MAT and LFIA positive, with 2ME-MAT titers ranging from 20 to 640. At least one dog in 4/21 (19.0%, 95% CI: 2.0-46.0%) households was seropositive. Despite the absence of seropositivity in individuals with AHD and the comparatively low seroprevalence in dogs, B. canis circulation and outbreaks should be considered in such human populations due to the high burden and recurrent character of B. canis exposure in high-density dog populations and the constant introduction of susceptible animals.
Assuntos
Brucella canis , Brucelose , Doenças do Cão , Transtorno de Acumulação , Animais , Cães , Humanos , Brucella canis/genética , Brucelose/diagnóstico , Brucelose/epidemiologia , Brucelose/veterinária , Doenças do Cão/diagnóstico , Doenças do Cão/epidemiologia , Saúde Única , Estudos SoroepidemiológicosRESUMO
PURPOSE: Animal hoarding has been associated with unhealthy human, animal and environmental conditions that predispose such individuals to serious life-threatening risks such as arson, malnutrition, cruelty and zoonosis. The study aimed to evaluate the presence of anti-Toxocara spp. antibodies among individuals with animal hoarding disorder in Curitiba, Brazil. METHODS: 65 residences with register of animal hoarder behavior were visited and 11 residences were included in the study, with a total of 19 individuals consenting participation. A short questionnaire was applied to gather information regarding hoarders and their dogs/cats, and serum samples were screened to detect antibodies (IgG) against antigens of Toxocara spp. RESULTS: Overall, 14/19 individuals (73.7%) presented anti-Toxocara spp. antibodies. In 8/11 (72.7%) households at least one person was seropositive. Seropositivity was higher among women (10/13; 76.9%) than men (4/6; 66.7%). A total of 442 dogs (14-30 dogs; average = 23.3 per household) and 31 cats (1-20 cats; average = 4.8 per household) were observed. To the authors' knowledge, this was the first study to survey occurrences of toxocariasis among animal hoarders. The high population densities of dogs observed during visits, in conjunction with absence of veterinary care and unsanitary conditions, may indicate that situations of high levels of animal infection and soil contamination were present. CONCLUSION: In summary, the seroprevalence observed in this study indicated that there was a high risk of Toxocara spp. infection among individuals with animal hoarding disorder. Provision of educational programs to reduce the risk of infection in this population is warranted.
Assuntos
Anticorpos Anti-Helmínticos , Doenças do Cão , Transtorno de Acumulação , Toxocara , Toxocaríase , Animais , Brasil/epidemiologia , Humanos , Cães , Toxocara/imunologia , Gatos , Feminino , Masculino , Toxocaríase/epidemiologia , Transtorno de Acumulação/epidemiologia , Estudos Soroepidemiológicos , Doenças do Cão/parasitologia , Doenças do Cão/epidemiologia , Anticorpos Anti-Helmínticos/sangue , Adulto , Doenças do Gato/parasitologia , Doenças do Gato/epidemiologia , Saúde Pública , Pessoa de Meia-Idade , Adulto Jovem , Inquéritos e Questionários , AdolescenteRESUMO
El trastorno de acumulación se caracteriza por una extrema dificultad para deshacerse o descartar artículos, independientemente de su valor real, originando con ello múltiples síntomas y problemas cotidianos de todo tipo. Aunque la severidad es más marcada en adultos mayores, el cuadro es de instalación progresiva a lo largo de varias décadas. Se presenta el caso de un paciente varón de 49 años, con inicio de la enfermedad desde los 15 años, guardando libros y cuadernos usados con la idea de que podrían ser útiles en el futuro; además de manifestaciones significativas de ansiedad. La acumulación de otros objetos como herramientas, ropa y utensilios de cocina se fue intensificando junto con el incremento de la ansiedad tras varias pérdidas familiares. El paciente buscó atención médica en diferentes centros sin encontrar alivio. Finalmente, el diagnóstico, el tratamiento psicofarmacológico y psicoterapéutico fueron replanteados con resultados favorables.
SUMMARY Hoarding Disorder is characterized by an extreme difficulty to get rid of or discard objects, regardless of their real value and originating multiple symptoms and everyday life problems. The severity is major in old adults although the condition progresses throughout several decades of life. The case of a 49 years old man is presented: the illness started at age 15, keeping used books and notebooks with idea that they would be necessary in the future. This was associated with significant anxiety in some social situations; later, other objects such as tools, clothes and cookware beside were added with intensified anxiety relate to emotional and family losses. The patient sought medical attention in several centers without relief. Finally, his diagnosis, psychopharmacological and psychotherapeutic treatment were re-framed with favorable results.
Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Psicotrópicos , Terapia Cognitivo-Comportamental , Colecionismo , Transtorno de Acumulação , Pacientes , Processos Psicoterapêuticos , DiagnósticoRESUMO
OBJECTIVE: In the present study, we aimed to perform a systematic review evaluating the cognitive performance of patients with hoarding disorder (HD) compared with controls. We hypothesized that HD patients would present greater cognitive impairment than controls. METHODS: A systematic search of the literature using the electronic databases MEDLINE, SCOPUS, and LILACS was conducted on May 2020, with no date limit. The search terms were "hoarding disorder," "cognition," "neuropsychology," "cognitive impairment," and "cognitive deficit." We included original studies assessing cognitive functioning in patients with HD. RESULTS: We retrieved 197 studies initially. Of those, 22 studies were included in the present study. We evaluated 1757 patients who were 41 to 72 years old. All selected studies comprised case-control studies and presented fair quality. Contrary to our hypothesis, HD patients showed impairment only in categorization skills in comparison with controls, particularly at confidence to complete categorization tasks. Regarding attention, episodic memory, working memory, information-processing speed, planning, decision-making, inhibitory control, mental flexibility, language, and visuospatial ability, HD patients did not show impairment when compared with controls. There is a paucity of studies on social cognition in HD patients, although they may show deficits. The impact of emotion in cognition is also understudied in HD patients. CONCLUSION: Except for categorization skills, the cognitive performance in HD patients does not seem to be impaired when compared with that in controls. Further work is needed to explore social cognition and the impact of emotion in cognitive performance in HD patients.
Assuntos
Transtornos Cognitivos , Disfunção Cognitiva , Transtorno de Acumulação , Humanos , Adulto , Pessoa de Meia-Idade , Idoso , Transtorno de Acumulação/psicologia , Testes Neuropsicológicos , Disfunção Cognitiva/etiologia , CogniçãoRESUMO
A política pública, enquanto exercício do poder público para resolver problemas da sociedade, é passível de aproximações para entendimento sobre seu funcionamento. Este trabalho faz esse exercício ao analisar as percepções dos profissionais atuantes em política municipal para atendimento a pessoas em situação de acumulação, de município da Região Metropolitana de Curitiba/PR. Para a construção da pesquisa qualitativa, de tipo exploratório-descritiva, utilizou-se entrevistas com profissionais do serviço municipal, após, o conteúdo foi analisado pela análise categorial temática. O transtorno de acumulação, caracterizado pela dificuldade em desfazer-se de objetos, tem como manifestação especial o acúmulo de animais e implica em sofrimentos para a própria pessoa e a coletividade. O Comitê Municipal para atendimento a essa situação é multiprofissional, viabilizando tratamento em saúde, assistência aos animais, orientações de cunho sanitário e demais intervenções pertinentes. A partir desse panorama geral, apreendeu-se que a multiprofissionalidade é imprescindível para o serviço, ao invés da concentração apenas na psicologia e psiquiatria. A evolução terapêutica do paciente é gradual e envolve reincidências, assim, as expectativas dos profissionais em relação aos casos atendidos, idealmente, precisa levar em conta a especificidade da condição de sofrimento do paciente, e prever alternativas àquelas que prescrevem a supressão dos sintomas apenas, como a perspectiva da redução de danos. (AU)
Public policy, as a means of the government's authority to solve society's problems, is passive of approaches for understanding how it functions. This dissertation intends to do as such, by analyzing the perceptions of professionals working with municipal policy to assist people living nearby Curitiba--PR city that struggles with Hoarding Disorder. To build the repertory for an exploratory-descriptive type of qualitative research, interviews with municipal service workers were collected, then, the content was analyzed using thematic analysis. Hoarding Disorder, distinguished by the difficulty in getting rid of acquired objects, has as special manifestation the acumulation of animals, and entails suffering for itself and the community. The Municipal Committee created to address this issue is multi-professional, enabling access to health care, animal care, sanitary guidelines, and other relevant interventions. From this survey, it was possible to understand that the multi-professional nature of the Committee is essential in this field, instead of concentrating only psychiatric and psychology professionals for the task. The patient's therapeutic evolution is gradual and involves recidivisms, therefore, the professionals' expectations regarding each case needs to, preferably, consider the specificity of the patient's suffering condition, and foresee alternatives that solely prescribe the suppression of symptoms, such as harm reduction. (AU)
La política pública, como ejercicio del poder público para resolver problemas de la sociedad, es posible de aproximaciones para entendimiento de su funcionamiento. Este trabajo haz ese ejercicio al analizar las percepciones de los profesionales actuantes en la política municipal de atendimiento a personas en situación de acumulación, del municipio de la Región Metropoli-tana de Curitiba/PR. Para la construcción de la pesquisa cualitativa, de tipo exploratorio-descriptiva, usamos entrevistas con profesionales del servicio municipal, después, el contenido fue analizado por el análisis temática. El trastorno de acumulación, caracterizado por la dificultad en deshacerse de objetos, tiene como manifestación especial la acumulación de animales, e implica en sufrimientos para la persona y la colectividad. El Comité Municipal para atendimiento a esa situación es multiprofesional, posibilitando trata-miento en salud, asistencia a los animales, orientaciones sanitarias y demás intervenciones pertinentes. A partir de ese panorama general, comprenderse que la multiprofesionalidad es imprescindible para el servicio, en lugar de apenas contratación de psicología y psiquiatría. La evolución terapéutica del paciente es gradual y muchas veces con recurrencias, así, las expectativas de los profesionales en relación con los casos atendidos, idealmente, necesita llevar en cuenta la especificidad de la condición del sufrimiento del paciente, y promover alternativas a aquellas que prescriban el desaparecimiento de los síntomas solamente, tal como la perspectiva reducción de los danos. (AU)
Assuntos
Humanos , Equipe de Assistência ao Paciente , Percepção , Transtorno de Acumulação/terapia , Política Pública , Poder Público , Pesquisa Qualitativa , Angústia PsicológicaRESUMO
BACKGROUND: Individuals with hoarding disorder (HD) presented a persistent difficulty in detaching from objects and/or animals. Unhealthy conditions, frequently found in cases of animal HD (AHD), may favour environmental contamination and the spread of zoonotic pathogens. Despite that, only one study of zoonotic diseases in individuals with AHD and their companion animals has been conducted to date. OBJECTIVES: This study aimed to assess the seroprevalence of anti-Leptospira spp. antibodies in individuals with AHD and their dogs in a major city of Southern Brazil. METHODS: Blood samples were obtained from 264 dogs (21 households) and 19 individuals with AHD (11 households) and tested by microscopic agglutination test. RESULTS: All human samples were seronegative. Seropositivity was found in 16/264 (6.1%; CI 95% 3.3-9.6%) dogs from 11/21 (52.38%) households, with titres ranging from 100 up to 400, and Copenhageni (10/16; 62.5%) was the most frequent serovar. Surprisingly, seropositivity of hoarded dogs found herein was among the lowest reportedly observed in other dog populations of Brazil. Two epidemiological variables were significantly associated with seropositivity in dogs: the presence of cat hoarding (p = 0.004) and the report of flood occurrence in the household (p = 0.031). CONCLUSIONS: No individuals with AHD were seropositive, and besides the lower seroprevalence of dogs, they probably had contact with Leptospira spp. at some point in their life. Since dogs can be considered potential sentinels in leptospirosis, public health programs must become aware of the risk of leptospirosis cases in households of individuals with AHD and nearby communities.
Assuntos
Doenças do Cão , Transtorno de Acumulação , Colecionismo , Leptospira , Leptospirose , Animais , Brasil/epidemiologia , Doenças do Cão/epidemiologia , Cães , Transtorno de Acumulação/epidemiologia , Leptospirose/epidemiologia , Leptospirose/veterinária , Estudos SoroepidemiológicosRESUMO
Objectives: Despite the inclusion of hoarding disorder (HD) in the DSM-5, there is little epidemiological data on hoarding from low and middle-income countries. This study, the first from India, examines the prevalence and correlates of HD among primary care patients in the state of Kerala, India. Methods: To assess correlates, the Hoarding Rating Scale-Interview (HRS-I) and other structured instruments were administered to 7,555 subjects selected by stratified random sampling from 71 primary health centers. Results: The prevalence of HD was 1.02% (95%CI 0.8-1.3). Those with HD were more likely to be older and live alone. In the binary logistic regression analysis, after controlling for significant sociodemographic variables, subjects with HD had a higher odds of reporting chronic illness, depression, anxiety disorder, alcohol abuse, and tobacco dependence. Subjects with HD had significantly higher disability scores than unaffected individuals. Conclusion: Although HD is not uncommon in India, this disorder is rarely reported in specialty settings in India, which suggests that awareness and detection should be improved, considering the co-occurring negative correlates and disability among affected individuals.
Assuntos
Humanos , Transtorno de Acumulação/diagnóstico , Transtorno de Acumulação/epidemiologia , Transtornos de Ansiedade , Atenção Primária à Saúde , Índice de Gravidade de Doença , PrevalênciaRESUMO
OBJECTIVES: Despite the inclusion of hoarding disorder (HD) in the DSM-5, there is little epidemiological data on hoarding from low and middle-income countries. This study, the first from India, examines the prevalence and correlates of HD among primary care patients in the state of Kerala, India. METHODS: To assess correlates, the Hoarding Rating Scale-Interview (HRS-I) and other structured instruments were administered to 7,555 subjects selected by stratified random sampling from 71 primary health centers. RESULTS: The prevalence of HD was 1.02% (95%CI 0.8-1.3). Those with HD were more likely to be older and live alone. In the binary logistic regression analysis, after controlling for significant sociodemographic variables, subjects with HD had a higher odds of reporting chronic illness, depression, anxiety disorder, alcohol abuse, and tobacco dependence. Subjects with HD had significantly higher disability scores than unaffected individuals. CONCLUSION: Although HD is not uncommon in India, this disorder is rarely reported in specialty settings in India, which suggests that awareness and detection should be improved, considering the co-occurring negative correlates and disability among affected individuals.
Assuntos
Transtorno de Acumulação , Transtornos de Ansiedade , Transtorno de Acumulação/diagnóstico , Transtorno de Acumulação/epidemiologia , Humanos , Prevalência , Atenção Primária à Saúde , Índice de Gravidade de DoençaRESUMO
Despite vulnerability and unsanitary conditions of animal hoarding may predispose environmental contamination and spread of vectors and pathogens, no study to date has focused on their impact on public health and zoonotic diseases. Accordingly, this study aimed to assess the seroprevalence of anti-Toxoplasma gondii antibodies and associated factors in individuals with animal hoarding disorder (AHD) and their dogs in Curitiba, Southern Brazil. Blood samples were obtained from 264 dogs (21 households) and 19 individuals with AHD (11 households). Their blood was tested by indirect fluorescent antibody test (IFAT). Overall, anti-Toxoplasma gondii seropositivity was found in 21/264 dogs (7.95%; 95% CI: 4.69-11.22) with titers ranging from 16 to 4096, and in 7/19 individuals with AHD (36.84%; CI: 15.15-58.53) with titers ranging from 16 to 64. Serological analysis for anti-T. gondii antibodies were considered positive in at least one individual or dog in 9/11 (81.82%; 95% CI: 59.03-100.00) cases that were thoroughly assessed. Surprisingly, the seropositivity of individuals with AHD and their dogs was among the lowest reportedly observed in human and dog populations of Brazil. There was no significant association between positive owners and positive dogs or the presence of cats in the household. Regard epidemiological variables, a significant association was found between dog's seropositivity and the type of dog food. To the authors' knowledge, the present study represents the first investigation of T. gondii seroprevalence in individuals with hoarding disorder and their dogs. In conclusion, despite low sanitary conditions, anti-Toxoplasma gondii antibodies frequency in individuals with AHD and their dogs are lower than the general population likely due to low protozoan load in such isolated households.
Assuntos
Anticorpos Antiprotozoários/sangue , Doenças do Cão/epidemiologia , Transtorno de Acumulação/epidemiologia , Toxoplasma/imunologia , Toxoplasmose/epidemiologia , Ração Animal , Animais , Brasil/epidemiologia , Doenças do Cão/sangue , Doenças do Cão/imunologia , Cães , Geografia Médica , Colecionismo/sangue , Colecionismo/epidemiologia , Colecionismo/imunologia , Transtorno de Acumulação/sangue , Transtorno de Acumulação/imunologia , Humanos , Estudos Soroepidemiológicos , Análise Espacial , Toxoplasmose/sangue , Toxoplasmose/imunologiaRESUMO
The main goal of this research is to describe the psychopathological symptoms comorbid to animal hoarding disorder. This is a cross-sectional study with a sample of a 33 individuals sample diagnosed with animal hoarding disorder. For data collection, a Sociodemographic Data questionnaire and a Semi-Structured Clinical Interview were used, based on the DSM-5 Level 1 Cross-Cutting Symptom Measure. The sample consisted of 24 women (72.7%) and 9 men (27.30%), with a prevalence of 64% of the elderly. The mean number of self-reported animals per residence was 41.12 (DP = 24.41), totaling 1357 animals: 915 (68%) dogs, 382 (28%) cats, and 50 (4%) ducks. The results indicated animal hoarding disorder the comorbid psychopathological symptoms of depression (36%), anxiety (36%), memory deficits (27%), mania (21%) and obsessive-compulsive disorder (18%). The analyses revealed a higher occurrence of these symptoms among participants who had hoarded animals for over 20 years.