Hoarding Disorder

About Hoarding Disorder

Hoarding disorder involves persistent difficulty discarding or parting with possessions regardless of their actual value, because of a perceived need to save items and distress associated with discarding them. The result is an accumulation of possessions that congests and clutters living areas so that they cannot be used as intended, causing significant distress or impairment and sometimes risks such as fire, falls and unsanitary conditions. Commonly saved items include newspapers, mail, clothing, books and containers. Many people also acquire excessively, through buying or collecting free items. Hoarding differs from ordinary collecting by its disorganization, distress and effect on daily living. DSM-5 recognized it in 2013 as a distinct disorder in the obsessive compulsive and related disorders chapter; previously it was often considered a symptom of OCD. Symptoms often begin in adolescence and tend to worsen with age, so the condition is frequently identified in older adults, and insight is often limited. It commonly co occurs with depression, anxiety and ADHD, particularly inattention. Animal hoarding is a related pattern involving accumulation of animals without adequate care. Specialized cognitive behavioral therapy for hoarding, which addresses motivation, decision making, organizing and practice with discarding and resisting acquiring, is the best studied treatment, and harm reduction approaches focus on safety when change is slow.