Today I present a guest post by Molly Nox.  Molly is an aspiring grad student in Clinical Psychology, with a keen interest in Compulsive Hoarding.


The Connection Between OCD & Hoarding

Individuals who have a hard time throwing anything away may end up with a big mess on their

hands. Even though their quality of life is impacted, their spouses object, and their children are

embarrassed to have friends over, hoarders are still unable to part with their accumulations.

Hoarders often suffer from other mood and anxiety disorders, and their clutter often reaches a

point where psychiatric intervention and professional hoarding cleanup services need to be

called in order to begin recovery from Hoarding Disorder.

What Is the Link Between Hoarding and OCD?

Obsessive compulsive disorder is a mental challenge in which the sufferer exhibits some sort of

irrational, repeated behavior and cannot seem to stop him or herself. Historically, psychologists

classified hoarding solely as a symptom of OCD; recently, after the publication of the DSM-5,

Hoarding Disorder has been recognized as a separate disorder completely.

It is true that many people who have Hoarding Disorder also suffer from OCD, but the link is not

as concrete as once believed. Approximately 18% of people who have Hoarding Disorder also

have been diagnosed with OCD. While this is a significant number, it is worth noting that a

staggering 92% of people with Hoarding Disorder also suffer from other psychiatric conditions,

with over 50% having clinical depression. It appears that Hoarding Disorder is not as closely

linked to OCD as it is with other disorders such as depression and General Anxiety Disorder.

Another aspect in which Hoarding Disorder and OCD differ is their treatment. In the past, people

who exhibited hoarding symptoms were diagnosed with OCD and treated accordingly. We now

know that people with hoarding symptoms are very unlikely to respond to traditional OCD

treatment. Hoarding Disorder is notoriously difficult to treat, but interventions targeted

specifically toward hoarding symptoms show the most promising success rates.

Why Does a Person Become a Hoarder?

While there is no clear consensus on the cause of Hoarding Disorder, there are a handful of

contributing factors to consider:

  • Genetics – Hoarding Disorder tends to run in families. Researchers have found patterns

in chromosome 14 that are unique to families with multiple hoarders.

  • Trauma – Trauma often plays a significant part in the onset or expression of hoarding

behavior. This does not necessarily mean that trauma is a cause of Hoarding Disorder; it

is, however, considered a factor that can cause a “break” in a person who is already

genetically predisposed.

  • Biology – A recent study found that individuals with Hoarding Disorder experienced

frontal brain hypoactivity. This is a condition that leads to decreased dopamine levels in

the brain and is commonly associated with addiction. Frontal brain hypoactivity is not as

common in people diagnosed with PTSD though, which is further evidence that OCD and

Hoarding Disorder are very different indeed.

Why Call a Mental Health Professional?

Hoarding Disorder is a condition that goes untreated in a worrisome 80% of cases. Many

hoarders either do not think they need treatment or think treatment will not help them.

Treatments for Hoarding Disorder have improved drastically in recent years, but public

perception has not improved with it.

If the accumulation of excessive things is negatively affecting the hoarder’s quality of life and

relationships, then psychiatric evaluation is highly recommended. Therapy can begin the process

of helping a hoarder understand their compulsions and eventually live a clutter-free life. It can

be helpful to seek a therapist who specializes in helping patients who suffer from compulsive

hoarding and its related disorders. Additionally, enlisting in professional cleaning services to

clean up the entire site can help make their home inhabitable again.


Molly Nox is a freelance writer based in Los Angeles. She’s a California dreamer with a penchant for handwritten letters, the New York Times, and dark roast coffee. Follow her on Twitter: http://www.twitter.com/mollynox


Thanks to the Kings College London Institute of Psychiatry (the same people doing the Hoarding Study I recently participated in), I’ve learned compulsive hoarding is likely to be included as a new mental disorder in the Diagnostic and Statistical Manual for Mental Disorders or DSM-5. DSM-5 is due to be published in 2013.  I’m hoping this means more research and attention being devoted to treating compulsive hoarding.  I also hope it means less people thinking hoarders are just lazy deadbeats who just need to throw a garage sale.  There’s something about this being made “official” that gives me some hope.

Below are the proposed diagnostic criteria for Hoarding Disorder. All criteria A-F must be met to qualify for the diagnosis.

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

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

C. The symptoms result in the accumulation of possessions that congest and clutter active living areas and substantially compromise their intended use. If living areas are uncluttered, it is only because of the interventions of third parties (e.g., family members, cleaners, authorities).

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).

E. The hoarding is not attributable to another medical condition (e.g., brain injury, cerebrovascular disease, Prader-Willi Syndrome).

F. The hoarding is not better accounted for by the symptoms of another DSM-5 disorder (e.g., hoarding due to obsessions in Obsessive-Compulsive Disorder, decreased energy in Major Depressive Disorder, delusions in Schizophrenia or another Psychotic Disorder, cognitive deficits in Dementia, restricted interests in Autism Spectrum Disorder).

For people meeting all diagnostic criteria A-F, the following ‘specifiers’ can be noted as well:

Specify if:

With Excessive AcquisitionIf symptoms are accompanied by excessive collecting or buying or stealing of items that are not needed or for which there is no available space.

Indicate whether hoarding beliefs and behaviors are currently characterized by:

Good or fair insight: The individual recognizes that hoarding-related beliefs and behaviors (pertaining to difficulty discarding items, clutter, or excessive acquisition) are problematic.

Poor insightThe individual is mostly convinced that hoarding-related beliefs and behaviors (pertaining to difficulty discarding items, clutter, or excessive acquisition) are not problematic despite evidence to the contrary.

*I believe this is where my Mother is, leaning towards Absent insight.

Absent insight (i.e. delusional beliefs about hoarding): The individual is completely convinced that hoarding-related beliefs and behaviors (pertaining to difficulty discarding items, clutter, or excessive acquisition) are not problematic despite evidence to the contrary.

You can find more information in the DSM-5 website.


I am posting this on behalf of the King’s College London where researchers have put together a study about compulsive hoarding.  I’ll be participating to help further the awareness of the effects of hoarding on relatives, and I encourage you to get involved if you’re in a similar situation.  I’m not eligible for the compensation since there’s no way I can get my Mom to participate, and I’m not being paid to post this for King’s College in any way.  I’ve been emailing back and forth with the researchers, though, and find them to be genuinely interested and quick to respond.  Here’s hoping they learn something positive towards coping with compulsive hoarding.

Hoarding Study Needs You

Researchers at King’s College London are currently carrying out a project investigating the impact of hoarding across important areas of life (e.g. memory and planning, acquisition, familial and other interpersonal relationships).

Currently, the team is looking for individuals who either identify as a hoarder OR have a relationship with someone who hoards to complete a series of online questionnaires (approximately 25 minutes) and, potentially, a brief telephone interview (approximately 15 minutes). Participation is accompanied by a small financial compensation of £5.

As a central question in this study concerns the impact of hoarding on relationships, the team is asking that all hoarders provide one person (spouse, parent, adult child or other close acquaintance) who would be willing to complete a similar, but separate, online survey. Likewise, if you are the spouse/parent/child/etc of a hoarder, then the research asks that your hoarding relative/friend be willing to complete that portion of the project.

If you’re interested in learning more, check out the study website (www.hoardingstudy.com) or contact a member of the research team directly at: helena.drury@kcl.ac.uk