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Compulsive hoarding is a psychiatric condition characterized by inability to dispose of excess or unused things up until the point where the belongings are choking up the patient’s living space.
For example, the person may be unable to access rooms, bathroom or even his or her bed due to the excessive clutter of the hoarded items. (1)
Hoarding commonly manifests as a house over full with stuff.
Hoarders often have logic behind collecting unused items. Like animals storing food for winter or farmers storing provisions and seeds for rough times the hoarders believe they would use the stored items someday.
As time progresses the hoarding cramps their living space so much so that they are unable to move about freely in the house.
However, moving even single items, will elicit panic from the hoarder.
The hoarder considers his or her house as a storage facility and would rather escape to other places to live than move the items. (1)
Compulsive hoarding also means acquiring new stuff as well. Sometimes this might manifest as uncontrolled shopping or buying or even scavenging.
Hoarding is different from collecting. A collector is proud of the collected things and wants to show them off.
A hoarder however does not want anyone in their home for fear that visitors might move or destroy something.
It might be years before a compulsive hoarder living alone is brought to notice. The situation worsens once the hoarder retires and/or becomes disabled. (1)
There may be three problems that are interlinked (2) –
Hoarding is usually seen in persons who have a family history of hoarding or they have experienced deprivation early in life.
Some hoarders have themselves grown up in cluttered homes.
They may have other conditions raising the risk of hoarding behaviors like social phobia (fear of social occasions), anxiety or depression or are struggling to cope with a stressful life event, such as the death of a loved one.
In many there may be substance abuse or alcohol dependence and there may be loneliness where hoarding brings comfort. (3)
The results of compulsive hoarding may be severe. There is fire risk or risk of infections and vermin.
In these cases government departments forcibly clear the hoarder’s protective cover and their homes.
This should be accompanied with treatment of the hoarder to prevent a recurrence.
Since most hoarders do not view their condition as a problem, treatment is a challenge. (1)
All patients with hoarding may not be suffering from compulsive hoarding.
Hoarding alone may be seen with various neuropsychiatric disorders like psychotic disorders, eating disorders, autism, dementia, and mental retardation.
The hoarders may also have no psychiatric disorder.
However, in most cases hoarders have associated obsessive compulsive disorder (OCD).
At least 25-40% of people with OCD may have compulsive hoarding behavior. (4)
Hoarding is also often associated with anxiety and depression.