New guidance on hoarding disorder: Key takes

UK: A new guidance by Dr Sharon Morein and Dr Sanjiv Ahluwalia of Anglia Ruskin University (ARU) may help doctors correctly diagnose hoarding disorder. Published in the British Journal of General Practice, the guidance may help health professionals spot the signs of hoarding disorder and intervene.

ARU experts have also organised a free conference on Wednesday, 10 May, to give the public more information about the condition.

Hoarding disorder affects around 2% of the population but remains a largely misunderstood mental health condition. It was only added to the International Classification of Diseases in 2019, having previously been classified under Obsessive Compulsive Disorder (OCD).

Hoarding disorder involves clutter in the home environment taking over living spaces and excessive acquisition and difficulty discarding possessions, affecting an individual’s quality of life.

However, it typically comes to the fore only when patients seek support for other mental health or physical conditions and can act as a treatment barrier due to concerns about hygiene, safety, or access to the home.

People with hoarding disorder most commonly suffer from depression, while other comorbidities include Obsessive Compulsive Disorder (OCD), and Attention Deficit Hyperactivity Disorder (ADHD).

Dr Morein, an Associate Professor in Psychology at Anglia Ruskin University (ARU) and leader of the ARU Possessions and Hoarding Collective said:

“Labels can be very useful in the healthcare system and can be the first stage for people receiving the support they need.

“It is really important that doctors and other frontline healthcare professionals are aware that hoarding disorder is a diagnosable medical condition and that it is usually linked to other issues so that proper support can be offered.

“Typically, hoarding disorder is something that sneaks up on people-it doesn’t happen overnight-and people don’t necessarily recognise they have a problem. One of the major difficulties with hoarding disorder is that sufferers often don’t seek help themselves, and it only presents itself to medical professionals alongside other issues. The sooner the problem is spotted, the sooner support can be provided.”

To help people understand more about hoarding disorder, the ARU Possessions and Hoarding Collective is hosting a free conference at ARU’s Cambridge campus on Wednesday, 10 May.

The event, which will feature expert speakers including Professor Nick Neave of Northumbria University, will explain more about the disorder and the latest support strategies, and is aimed at service providers who help people with hoarding as part of their role, those affected by the hoarding behaviour of others, as well as individuals who themselves are struggling with hoarding.

Dr Morein added:

“The ARU Possessions and Hoarding Collective is a group of academics and professionals aiming to improve our understanding of how people interact with their possessions.

“As part of our work, we research how hoarding can affect individuals and their families, as well as how service provision is currently delivered, and how it can be improved. We are inviting all these groups to attend the event in Cambridge on 10 May as we aim to increase awareness and ultimately provide better support for all.”

Key takes

1.Hoarding disorder (HD) only exists as a psychiatric condition with clear diagnostic criteria since 2013, hampering research and treatment.

2.Symptoms include difficulty discarding possessions and their excessive accumulation and clutter of active living areas to the degree that compromises their intended use.

3. Individuals with HD are often characterised by limited insight, which can be exacerbated by stigma, with both substantially inhibiting disclosure and help-seeking to healthcare professionals.

4. Living conditions can directly impact patient wellbeing and safety and others in the home, visitors, and at times also those living in close physical proximity.

5. A diverse set of front-line providers can often be the first to encounter individuals with HD (for example, housing officers, environmental health, fire, police, and ambulance services). Still, it may not have a long-term relationship with the individual or appropriate clinical training.

6. Current best practice entails close and coordinated engagement with all relevant agencies to facilitate long-term patient-centred support and care.

Reference:

Sharon Morein-Zamir and Sanjiv Ahluwalia, British Journal of General Practice 2023; 73 (729): 182-183. DOI: https://doi.org/10.3399/bjgp23X732513.