Hoarding behaviour: special features and complications in real-world clinical practice

Abstract

Objective

Hoarding behaviour is a common but poorly characterised problem in real-world clinical practice. Although hoarding behaviour is the key component of Hoarding Disorder (HD), there are people who exhibit hoarding behaviour but do not suffer from HD. The aim of the present study was to characterise a clinical sample of patients with clinically relevant hoarding behaviour and evaluate the differential characteristics between patients with and without HD.

Methods

This study included patients who received treatment at the home visitation program in Barcelona (Spain) from January 2013 through December 2020, and scored ≥ 4 on the Clutter Image Rating scale. Sociodemographic, DSM-5 diagnosis, clinical data and differences between patients with and without an HD diagnosis were assessed.

Results

A total of 243 subjects were included. Hoarding behaviour had been unnoticed in its early stages and the median length in the sample was 10 years (IQR 15). 100% of the cases had hoarding-related complications. HD was the most common diagnosis in 117 patients (48.1%).

Conclusions

The study found several differential characteristics between patients with and without HD diagnosis. Alcohol use disorder could play an important role among those without HD diagnosis. Home visitation programs could improve earlier detection, preventing hoarding-related complications.

KEY POINTS

• Hoarding behaviour often goes unnoticed in mental health and in early stages.

• Complications due to accumulation are very common.

• All subjects included in this study had severe hoarding and multiple complications from hoarding, even those who did not meet diagnostic criteria for HD.

• Alcohol use disorder is often linked to non-HD patients

• Home visitation programs could improve earlier detection of hoarding behaviour.

Keywords:

• hoarding
• hoarding disorder
• clinical practice
• home treatment
• public health

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This research did not receive any grants from funding agencies in the public, commercial, or not-for-profit sectors.