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Disease: Hoarding Hoarding
Category: Psychiatric diseases
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Disease Definition:

The excessive collection of items and the inability to discard them is called hoarding. Usually, hoarding creates cramped living conditions, in which homes could be filled to capacity, with only narrow pathways winding through stacks of clutter. Some people may also collect animals and keep dozens or hundreds of pets in unsanitary conditions.

Also called compulsive hoarding and compulsive hoarding syndrome, hoarding could be a symptom of OCD (obsessive-compulsive disorder). However, many people who hoard don't have other OCD-related symptoms, and researchers are still working to better understand hoarding as a distinct mental health problem.

Treatment for hoarding is challenging because people who hoard don't see it as a problem. However, intensive treatment could help people who hoard understand their compulsions and live a safer, more enjoyable life.

Work Group:

Prepared by: Scientific Section

Symptoms, Causes


Usually, the countertops, sinks, desks, stoves, stairways and virtually all other surfaces are stacked with stuff in the homes of people who engage in compulsive hoarding. The clutter could spread to the garage, vehicles and yard when there's no more room inside.

Emotions, thoughts and behavior are affected by hoarding. Some of the signs and symptoms of hoarding may include:


  • Cluttered living spaces
  • Moving items from one pile to another without discarding anything
  • Excessive attachment to possessions, and discomfort letting others touch or borrow them
  • Difficulty managing daily activities, such as procrastination and trouble making decisions
  • Limited or no social interactions
  • Keeping stacks of newspapers, magazines or even junk mail
  • Difficulty organizing items
  • Acquiring unneeded or seemingly useless items, including trash
  • Perfectionism
  • Inability to discard items

People who engage in hoarding believe that these items will be needed or have value in the future, so they collect them. A person could also hoard items in case he/she feels that they have important emotional significance, for instance which could serve as a reminder of happier times or represent beloved people or pets. People who hoard may feel safer when they are surrounded by the things that they collect.

People who hoard animals could collect dozens or sometimes even hundreds of pets. Usually, they hoard animals that could be confined inside and are easier to conceal. In most cases, these animals aren't cared for properly because of their sheer numbers. When owners seek help for a steady stream of sick or injured pets, veterinarians could be the first to notice signs of animal hoarding.

Hoarding could range from mild to severe. Although is some cases hoarding could affect a person on a daily basis, however, in other cases, it may not have much effect on a person's life.

The fist symptoms of hoarding are usually clutter and difficulty discarding things. Usually, during teenage years, these early indications of a problem start surfacing. As a person who is affected with this disorder grows older, he/she will start acquiring things that they have no need. Symptoms often become severe and difficult to treat by middle age, which is when the condition is usually diagnosed.

A person should talk with a doctor or a mental health provider in case they or a loved one has symptoms of hoarding. There are some communities that have agencies that help with hoarding problems.

When health or safety is at stake, someone may need to contact the local authorities, such as police, fire, public health or animal welfare agencies.


The exact cause of hoarding is still not clear. Hoarding is believed to occur on a continuum, although some people may simply be considered harmless pack rats, however, others may have a more severe form of collecting that is life-threatening. Some of the likely triggering factors could be genetics and upbringing, because this condition is more likely to affect those with a family history of hoarding.

Currently, hoarding is considered a subtype of OCD; however, this classification is still under debate. Although some people with OCD may have hoarding behavior, however, hoarding is not specific to OCD. One study has found that hoarding is no more likely to be associated with OCD than with other anxiety disorders.

To understand the biological and environmental factors that seem to play a role in hoarding, research is still ongoing. Hoarding may be classified as a new and separate mental health disorder, depending on the findings from these studies.



A variety of complications could be caused by hoarding, such as:


  • Unsanitary conditions that pose a risk to health
  • Poor work performance
  • A fire hazard
  • Loneliness and social isolation
  • An inability to perform daily tasks, including cooking or bathing.


Treating hoarding is usually a challenge, and meets with mixed success. Many people who have this disease don't believe that they need treatment or don't recognize the negative impact of hoarding on their lives. In case the possessions or animals of these people offer comfort, the situation mentioned above could be especially true. When the animals of people who suffer from hoarding are taken away, they may collect more to help fulfill emotional needs.

Because the best treatment for hoarding hasn't been found yet, treating this condition could be quite difficult. A person should find a therapist or other mental health provider with experience in treating hoarding. Therapy usually pays off in the long run, despite the fact that it could be intense and time-consuming, taking many months or even years.

Psychotherapy and medications are the two main types of treatment for hoarding.

The most common form of psychotherapy that is used to treat hoarding is cognitive behavior therapy. During cognitive therapy someone might:


  • Attend family or group therapy
  • Explore why they feel compelled to hoard
  • Improve their decision-making skills
  • Learn and practice relaxation skills
  • Be encouraged to consider psychiatric hospitalization if their hoarding is severe
  • Learn to organize and categorize possessions to help them decide which ones to discard
  • Declutter their home during in-home visits by a therapist or professional organizer
  • Have periodic visits or ongoing treatment to help them keep up healthy habits.

To find the most effective ways to use medications in treatment of hoarding, research is still ongoing. SSRIs (selective serotonin reuptake inhibitors), a type of antidepressant, are the most commonly used medications for hoarding.
Obsessive-compulsive disorder could be effectively treated with these medications. Studies have been made to test SSRIs as a treatment for hoarding symptoms; however, they have found varied results. Some research has found that the SSRI drug paroxetine may improve hoarding symptoms in addition to other symptoms associated with OCD, while another research has suggested that people with hoarding symptoms are less likely to respond to SSRIs.


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