Hoarding Disorder - Anatomy of Psych

What is hoarding disorder?

Hoarding disorder is a disorder characterized by persistent difficult discarding or parting with possessions, regardless of their actual value, due to a strong perceived need to save the items. There is extreme distress associated with discarding these items. Hoarding disorder was previously listed as a symptom of obsessive-compulsive disorder but was reclassified as its own disorder in the DSM-5. The estimated prevalence is 2-6%.

What does hoarding disorder look like?

Signs & Symptoms

DSM-5 Criteria

Criterion A. Persisitent difficulty discarding or parting with possessions, regardless of their actual value.

Criterion B. This difficulty is due to a perceived need to save the items and to distress associated with discarding them.

Criterion C. The difficulty discarding possessions results in the accumulation of possessions that congest and clutter active living areas and substantially compromises their intended use. If living areas are uncluttered, it is only because of the interventions of third parties.

Criterion D. The hoarding causes clinically significant distress or impairment in social, occupational, or other important areas of functioning, including maintaining a safe environment for self and others.

Criterion E. The hoarding is not attributable to another medical condition.

Criterion F. The hoarding is not better explained by the symptoms of another mental disorder.

Specifiers

Risk Factors

Stressful or traumatic life events
50% of affected individuals have a relative who is also affected

Prognosis

Chronic course of illness
Low marriage and high divorce rates
80-90% of individuals exhibit excessive acquisition in the form of excessive purchases and acquisition of free items
Unsanitary living conditions due to severe clutter
Conflict with neighbors and authorities
Risk for eviction

Differential Diagnosis