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How Common Is Hoarding Disorder?

Summary and Comment |
November 12, 2013

How Common Is Hoarding Disorder?

  1. Peter Roy-Byrne, MD

This new DSM-5 diagnosis is not rare, and hoarders are older, poorer, unpartnered, and less healthy and have more mental-health comorbidities.

  1. Peter Roy-Byrne, MD

Individuals with pathological hoarding refuse to discard objects and accumulate such clutter in their homes that these become close to uninhabitable. Previously thought to be a variant of obsessive-compulsive disorder (OCD), the syndrome has recently been viewed as distinct, difficult to treat, and extremely disabling. To determine its prevalence, researchers used a population-based health survey of 1698 London residents (age range, 16–90) and in-home interviews of 99 of 201 subjects screening positive on a single question about hoarding.

After in-home interviews and environment ratings, only 19% of respondents with positive screens met criteria for hoarding, giving a prevalence of 1.5%. Examination of descriptions of the in-home environment in screen-negative subjects yielded a potential 28 more cases. Hoarders were more likely to be older, poorer, and without a partner and to have a physical health condition and comorbid mental disorder. Only a third had sought help in the past year.

Comment

Hoarding disorder is as common as obsessive-compulsive disorder, schizophrenia, bipolar illness, and autism; often adversely affects family and caretakers; and yet has been infrequently investigated. No medications are known to help, although a recently developed approach using cognitive-behavioral therapy may hold some promise. Unfortunately, this study did not measure cognitive function, which has also been shown to be diminished in hoarders. The results remind clinicians that two thirds of patients volunteering that they are “hoarders” may not have this disorder, although those that do are likely to have considerable medical and psychiatric comorbidities.

  • Disclosures for Peter Roy-Byrne, MD at time of publication Equity Valant Medical Solutions Grant / research support NIH-NIDA; NIH-NIMH Editorial boards Depression and Anxiety; UpToDate Leadership positions in professional societies Anxiety Disorders Association of America (Ex-Officio Board Member); Washington State Psychiatric Society (Treasurer)

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Reader Comments (2)

Armando Rayas Physician, Pediatrics/Adolescent Medicine, Hospital and medical office

This problem is common in our country (Mexico)

DAVID KARNEY Physician, Psychiatry, Office Practice

Interested in practical thoughts and ideas for the management of the hoarder in the outpatient general psychiatry setting.

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