Hoarding Disorder

Persistent difficulty discarding possessions due to a perceived need to save them, leading to clutter and distress.

Etiology (Biopsychosocial Model)

Biological: Executive function deficits.

Psychological: Sentimentality, perfectionism, decision paralysis.

Social: Isolation, family modeling, traumatic loss.

Symptoms & Diagnosis (Mnemonic: CLUTTER):

C - Cluttered living spaces

L - Letting go is distressing

U - Unused items accumulate

T - Trouble making decisions

T - Third-party interventions common

E - Emotional attachment to items

R - Rules out other causes (e.g., OCD, neurocognitive disorder)

Treatment

CBT with focus on decision-making and organization

Motivational interviewing

SSRIs may have limited effect

Info

DSM-5-TR Code

F42.3

Prevalence

2%–6%; typically chronic and progressive.