Hoarding Disorder: The Current Evidence in Conceptualization, Intervention, and Evaluation

Psychiatr Clin North Am. 2023 Mar;46(1):181-196. doi: 10.1016/j.psc.2022.10.007. Epub 2022 Dec 13.

Abstract

Hoarding disorder is characterized by difficulty parting with possessions due to strong urges to save the items, leading to the excessive accumulation of items. High clutter levels result in varied personal, social, and legal consequences. Specialized treatments, including individual, virtual, and group cognitive and behavioral therapies, community-based interventions, and peer support approaches have shown preliminary effectiveness. Animal, attachment, and neurobiological models are expanding our understanding of the etiological bases of the disorder. Specialized populations such as children, older adults, and involuntary patients are highlighted as requiring special consideration for intervention and risk mitigation. Directions for future research are identified.

Keywords: CBT; Clinical treatment; Community-based response; Hoarding disorder; Medication; Special populations.

Publication types

  • Review

MeSH terms

  • Behavior Therapy
  • Cognitive Behavioral Therapy*
  • Concept Formation
  • Hoarding Disorder* / psychology
  • Hoarding Disorder* / therapy
  • Humans