Prevalence of hoarding disorder among primary care patients

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.

Ethical gaps in conducting research among adult survivors of child sexual abuse: A review

Although there have been numerous studies, especially in the last few decades, on the impact of child sexual abuse (CSA) on adult survivors, there is a dearth of studies focusing on the ethical aspects of research in this area. Against this background, we reviewed the literature published between January 2000 and December 2016 on the reporting of ethical guidelines followed in research on adult survivors of CSA. We conducted a PubMed (MEDLINE) and Google Scholar search to find published research, using the keywords: “child sexual abuse”, “adult survivors”, “research”, “guidelines” and “ethics”. Our findings suggest that no particular assessment method is superior in terms of disclosure of information or reduction of distress. The use of developmentally appropriate educative materials, sensitisation, and debriefing sessions have shown some benefit in reducing distress. There is a lack of legal or social consensus on mandatory legal reporting of information provided by adult survivors of sexual abuse, with most researchers working on the premise that adults have the freedom of choice. Often, a constraint among researchers is the lack of structured training or supervision in sensitive research, which may negatively impact both the participant and the researcher. Institute ethics boards and institutions currently lack the framework to consider protocols and facilitate research, and this poses serious obstacles to fostering research. In this situation, ongoing research needs to focus on ethical aspects. Together with this, we recommend certain ethical practices drawn from various studies that may be employed for participants, researchers, and institutional ethics boards.