Hoarding disorder

A mental disorder manifested by persistent difficulty in discarding or parting with possessions.

Most common saved articles:newspapers, old clothing, bags, books, and paperwork.

Saved items range from worthless to valuable.

Patients attribute disorder to perceived usefulness or aesthetic value of items, strong sentimental attachment to possessions, avoiding the creation of waste or a combination of above.

Patients excessively acquire items that they do not need or for which no space is available.

Most patients have limited insight into their problems and are reluctant to seek help.

The prospect of discarding or parting with of possessions causes distress to the patient.

Results of hoarding: disorganized accumulation of possessions, cluttered living areas, distress, impaired social, occupational, and function, and inability to maintain a safe environment.

Clutter may prevent persons with hoarding disorder from being able to sleep in their bed, sitting in their living room, cooking in their kitchen or impair use of other spaces such as vehicles, yards, workplace, and relatives homes.

Severe hoarding may result in increased risks of fire, falling, poor sanitation and health.

Associated with impaired quality of life, and increase family distress.

75% of patients with a hoarding disorder have concurrent mood or anxiety disorders.

Attention deficit hyperactivity disorder, particularly inattention is a common characteristic of hoarders.

Hoarders, particularly older individuals, have worse general health and more medical problems than age matched controls.

Prevalent 2-6% among adults and 2% among adolescents.

The course is most often chronic and progressive.

Typically begins early in life, often in the early teenage years, and increases in severity with age.

Symptoms often start interfering with everyday functioning by the mid-20s and has clinical significant impairment by mid 30s.

Causes unknown, but does run in families.

In twin studies approximately 50% of the variance in hoarder’s behavior is related to genetic factors with the remaining variation attributed to environmental influences.

Individuals with hoarding disorder often reports stressful and traumatic life events that preceded the onset or exacerbation of the disorder.

Childhood material deprivation does not lead to hoarding.

Diagnosis is by direct psychopathological interview with the individual, especially in the person’s home with the ability to assess the extent of clutter and impairment.

Intervention is with cognitive behavioral therapy.

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