Harvard Mental Health Letter

Helping compulsive hoarders

Questions remain about what causes this disorder and how best to intervene.

Piles of newspapers stacked in the living room, leaving only a narrow path to the kitchen. Dozens of cats living in filthy conditions in a tiny house. Debris spilling out into the yard, prompting complaints from neighbors. All of these are signs of compulsive hoarding.

Although the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) does not list compulsive hoarding as a disorder, as we've reported in the past, this type of behavior traditionally has been viewed as a subtype of obsessive-compulsive disorder (OCD). About 25% to 30% of patients with OCD — or 0.4% of the U.S. population — develop hoarding behaviors.

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