Exercise for Hoarding Disorder

(Exercise BDNF Trial)

Overseen By Hannah Levy, PhD

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: Hartford Hospital

Disqualifiers: Cardiovascular, Metabolic, Renal, others

Stay on Your Current Meds You can continue your current medications while participating

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 2

22 Participants Needed

Trial Summary

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications. It's best to discuss this with the trial coordinators or your doctor.

What data supports the effectiveness of the treatment Brief Exercise Intervention for Hoarding Disorder?

Research suggests that adding structured physical exercise to cognitive-behavioral therapy (CBT) for obsessive-compulsive disorder (OCD) can significantly improve treatment outcomes. Since hoarding disorder is related to OCD, exercise might also help reduce symptoms in hoarding disorder when combined with other therapies. ^{1 2 3 4 5}

Is exercise generally safe for humans?

Exercise is generally considered safe for humans and is often included in treatment plans for various conditions, such as eating disorders and obsessive-compulsive disorder, with adaptations to ensure it is appropriate for the individual's health status. ^{3 4 5 6 7}

How does the Brief Exercise Intervention treatment for Hoarding Disorder differ from other treatments?

The Brief Exercise Intervention for Hoarding Disorder is unique because it focuses on incorporating physical exercise as a treatment strategy, which is relatively unexplored for this condition. Unlike traditional therapies that may focus on cognitive or pharmacological approaches, this intervention leverages the potential mental health benefits of exercise, similar to its use in treating other psychiatric disorders like OCD. ^{1 2 4 5 8}

What is the purpose of this trial?

Hoarding disorder (HD) is characterized by difficulty discarding personal possessions due to significant emotional distress when parting with personal items. This leads to the accumulation of excessive clutter which compromises the normal use of living spaces. In addition to emotional distress, individuals with HD experience significant impairment in physical health. One study found an 11-fold increase in stroke risk, a 10-fold increase in cancer risk, and a 7-fold increase in cardiovascular disease in individuals with HD relative to a general population comparison group. Patients with HD are also more likely to experience obesity and metabolic diseases such as diabetes. The short-term goal of the proposed study is to determine whether a brief exercise intervention improves discarding-related distress and brain-derived neurotropic factor (BDNF) in individuals with HD relative to a relaxation control condition. Preliminary evidence suggests that BDNF may be associated with greater body mass index and more severe HD symptoms in patients with HD. BDNF is a well-studied growth factor which is involved in neuronal transmission, plasticity, and survival of many neuron systems that have been implicated in psychiatric disorders, including serotonin, glutamate, and dopamine. BDNF has been proposed as a mechanism of exercise interventions for psychiatric disorders, as even one session of exercise has been shown to increase BDNF levels. This study represents an initial first step towards the long-term goal of improving current treatments for HD. This is important because although current cognitive-behavioral treatments (CBT) are effective, only 35% of patients who receive these treatments actually benefit from them. In the proposed pilot study, the investigators will test whether 30 minutes of moderate-intensity exercise reduces the distress associated with discarding and increases BDNF levels in individuals with HD relative to a relaxation control. The investigators will recruit 22 individuals with a primary diagnosis of HD. They will be randomly assigned to exercise or control. Following the intervention, the investigators will assess BDNF via serum. Participants will complete a standardized discarding task which consists of sorting and discarding personal possessions. The central hypothesis is that those in the exercise condition will demonstrate lower distress during the discarding task and greater BDNF levels as compared to those in the relaxation control condition. Should the hypothesis be confirmed, the investigators will be well poised to conduct large-scale clinical trials testing exercise interventions as adjunctive or alternative treatments to standard CBT.

Research Team

Hannah Levy, PhD

Principal Investigator

Hartford Hospital

Eligibility Criteria

This trial is for individuals with Hoarding Disorder (HD), characterized by difficulty discarding possessions and cluttered living spaces. Participants should have a primary diagnosis of HD to join the study, which aims to explore if exercise can help reduce distress associated with discarding items.

Inclusion Criteria

My primary diagnosis is hoarding disorder.

I am between 45 and 65 years old.

Exclusion Criteria

I don't have heart, kidney, metabolic diseases, thyroid issues, or uncontrolled high blood pressure that would stop me from exercising.

History of bipolar disorder

History of schizophrenia

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Intervention

Participants are randomly assigned to either a 30-minute moderate-intensity exercise session or a relaxation control condition

1 day

1 visit (in-person)

Assessment

Assessment of BDNF levels via serum and completion of a standardized discarding task

1 day

1 visit (in-person)

Follow-up

Participants are monitored for safety and effectiveness after the intervention

4 weeks

Treatment Details

Interventions

• Brief Exercise Intervention

Trial Overview The study tests whether a brief, 30-minute moderate-intensity exercise session can lower the emotional distress linked to throwing away possessions in people with HD compared to a relaxation control group. It also examines if this physical activity increases levels of BDNF, a protein potentially connected to HD severity.

Participant Groups

Group I: Relaxation Control Condition Experimental Treatment 1 Intervention

For participants randomized to the control group, they will sit in the testing room and watch informational videos about animals.

Group II: Exercise Condition Active Control 1 Intervention

For participants randomized to the exercise intervention, they will complete 30 minutes of brisk walking around the campus. They will be asked to maintain at least a moderate level of exercise intensity throughout the 30-minute walk.

Who Is Running the Clinical Trial?

Hartford Hospital

Lead Sponsor

Trials

140

Recruited

19,700+

University of Miami

Collaborator

Trials

976

Recruited

423,000+

Findings from Research

A scoping review of 10 studies and 6 reviews from 2021-2023 found that supervised and adapted physical activity (PAE) effectively managed dysfunctional exercise (DEx) in individuals with eating disorders, showing low-to-moderate health impacts and no adverse events.

For anorexia nervosa, PAE improved physical fitness without affecting body weight unless resistance training was included, while for bulimia nervosa, DEx decreased alongside increased functional exercise, highlighting the potential benefits of PAE in treatment.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

How to address physical activity and exercise during treatment from eating disorders: a scoping review. Mathisen, TF., Hay, P., Bratland-Sanda, S.[2023]

References

1. England pubmed.ncbi.nlm.nih.gov

A Pilot Test of the Additive Benefits of Physical Exercise to CBT for OCD. [2018]

2. United States pubmed.ncbi.nlm.nih.gov

Assessment and treatment of compulsive exercise in anorexia nervosa - A combined investigation of Compulsive Exercise Activity Therapy (LEAP) and Compulsive Exercise Test subscales. [2023]

3. England pubmed.ncbi.nlm.nih.gov

Compulsive exercise and eating disorders. [2022]

4. England pubmed.ncbi.nlm.nih.gov

Design and Rationale for a Randomized Controlled Trial Testing the Efficacy of Aerobic Exercise for Patients with Obsessive-Compulsive Disorder. [2022]

5. England pubmed.ncbi.nlm.nih.gov

Taking the LEAP: study protocol for a randomized, multicentre, naturalistic, efficacy trial of the compuLsive Exercise Activity theraPy (LEAP) - a cognitive behavioral program specifically targeting compulsive exercise in patients with eating disorders. [2021]

6. United States pubmed.ncbi.nlm.nih.gov

How to address physical activity and exercise during treatment from eating disorders: a scoping review. [2023]

7. England pubmed.ncbi.nlm.nih.gov

Treatment of compulsive exercise in eating disorders and muscle dysmorphia: protocol for a systematic review. [2021]

8. England pubmed.ncbi.nlm.nih.gov

Compulsive exercise in eating disorders: proposal for a definition and a clinical assessment. [2022]