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Psychiatry12 papers

Hoarding disorder

Last edited: 4/15/2026

Overview

Hoarding disorder is characterized by persistent difficulty discarding or parting with possessions, regardless of their actual value, leading to clutter that impairs living spaces and causes significant distress or functional impairment 23.

Diagnosis

  • Central feature involves accumulation of items due to an unwillingness to discard them 2.
  • Hoarding must be distinguished from normal collecting or accumulation driven by lack of awareness or motivation 2.
  • Emotion dysregulation shows a medium to strong association with hoarding symptoms, though variability exists across populations and measures 1.
  • Management

  • Cognitive-behavioral therapy (CBT) specifically tailored for hoarding disorder is considered first-line treatment 3.
  • Medications targeting underlying conditions like depression or anxiety may be adjunctive but specific drug classes/doses are not detailed in the provided abstracts 3.
  • Special Populations

  • No specific guidance provided for pregnancy, pediatrics, elderly, or comorbidities in the given abstracts 123.
  • Key Recommendations

  • Incorporate assessment of emotion dysregulation in the evaluation of hoarding disorder to better understand symptomatology (Evidence: Moderate) 1.
  • Clearly differentiate hoarding disorder from normal collecting behaviors and from OCD manifestations to guide appropriate clinical intervention (Evidence: Expert opinion) 23.
  • Prioritize cognitive-behavioral interventions specifically designed for hoarding disorder as the primary treatment approach (Evidence: Expert opinion) 3.
  • References

    1 Akbari M, Seydavi M, Mohammadkhani S, Turchmanovych N, Chasson GS, Majlesi N et al.. Emotion dysregulation and hoarding symptoms: A systematic review and meta-analysis. Journal of clinical psychology 2022. link 2 Snowdon J. Accumulating too much stuff: what is hoarding and what is not?. Australasian psychiatry : bulletin of Royal Australian and New Zealand College of Psychiatrists 2015. link 3 Rachman S, Elliott CM, Shafran R, Radomsky AS. Separating hoarding from OCD. Behaviour research and therapy 2009. link

    Original source

    1. [1]
      Emotion dysregulation and hoarding symptoms: A systematic review and meta-analysis.Akbari M, Seydavi M, Mohammadkhani S, Turchmanovych N, Chasson GS, Majlesi N et al. Journal of clinical psychology (2022)
    2. [2]
      Accumulating too much stuff: what is hoarding and what is not?Snowdon J Australasian psychiatry : bulletin of Royal Australian and New Zealand College of Psychiatrists (2015)
    3. [3]
      Separating hoarding from OCD.Rachman S, Elliott CM, Shafran R, Radomsky AS Behaviour research and therapy (2009)

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