Compulsive hoarding may become diagnosis distinct from OCD

While there is nothing wrong with light clutter or a junk drawer, what if an entire room — or even home — becomes jam-packed with items the owner cannot throw away?

Hoarding, like other compulsive behaviors, is an effort to manage anxiety. Those suffering the disorder hold on to things for comfort or sentimental reasons.

 

Compulsive hoarders are often diagnosed with obsessive compulsive disorder. For the first time, trials are under way to see if the condition warrants its own diagnosis.

Hoarding is similar to compulsive hand washing or cutting. But unlike these forms of OCD where the sufferers understand their actions and thoughts aren’t normal, hoarders have less insight on their habits. They don’t know they have a problem.

Psychologist Randy Frost, who has been studying hoarding for 20 years, said he’d like to see the disorder separated from OCD.

He said classic OCD sufferers have unpleasant thoughts and then create rituals to alleviate them. Hoarders are different.

“We see pleasure in these folks in their symptoms. When someone with a hoarding problem is out somewhere and acquiring things, what we see is a high,” he said. “It’s a little bit like an addiction in that sense.”

He said if hoarding becomes a distinct diagnosis, it will increase interest in the disorder and research will expand. Frost said up to 3 percent of people in the U.S. are hoarders, but only 2 percent have OCD.

Linda Welsh of the Philadelphia chapter of the National Obsessive-Compulsive Foundation said hoarding is the hardest compulsive behavior to treat.

“It’s very easy to convince yourself that there’s always going to be a need and there’s always some comfort and relief in holding on to things,” she said. “So getting someone to give something up when they can rationally, at least they think, come up with a reason to hold on to it, it’s very difficult.”

The University of Pennsylvania is one of seven institutions in trials testing how it works to classify hoarding as a separate disorder. The trials are part of the revisions of the Diagnostic and Statistical Manual of Mental Disorders or the “bible of psychiatry.” The new edition of the manual will be published in 2013.