Skip to main content
SpringerLink
Log in

A Review of the Diagnosis and Management of Hoarding Disorder

  • Anxiety, Obsessive Compulsive and Related Disorders (B Brennan and D Dougherty, Section Editors)
  • Published:
Current Treatment Options in Psychiatry Aims and scope Submit manuscript

Opinion statement

Hoarding disorder (HD) is a severe psychiatric and public health problem characterized by extreme challenges with discarding possessions and severe acquisition resulting in excessive clutter that impairs daily functioning and may cause substantial health and safety risks. Over the past 20 years, research on HD has grown substantially and lead to its recent designation in the DSM-5 as a discrete disorder. The key features of the cognitive behavioral etiological model of hoarding include core vulnerabilities, information processing deficits, cognitions and meaning of possessions, and emotionally driven reinforcement patterns. This model has served as the theoretical foundation for efficacious, specialized cognitive behavioral treatment (CBT) for hoarding and validated hoarding assessment measures. The individual manualized CBT treatment has been adapted for delivery through various modalities (e.g., group, web-based, self-help), populations (e.g., geriatric), and providers (e.g., clinicians, peer support, case managers). While CBT is associated with significant reductions in hoarding severity, clinical levels of hoarding symptoms persist for greater than half of treatment completers; thus, more efficacious treatments need to be developed. Further research is necessary to elucidate components of the CBT model and their interaction, in order to inform treatment targets. Although research on pharmacological treatments for HD is in the nascent stages and extant results are somewhat mixed, future studies may assess medication as a standalone treatment or combined with CBT. Family-focused hoarding interventions may also be important given that persons with hoarding behaviors may have limited insight and motivation and its negative effects on the family. Current data indicate a cost-effective and coordinated response that combines community-based and individualized interventions for hoarding may be optimal in order to (1) reach the broadest group of clients with hoarding (e.g., beyond those who voluntarily seek treatment), (2) maximize incentives and motivation through housing, health services, and safety laws, (3) enhance communication and coordination between diverse teams of providers, (4) provide sustainable comprehensive services in a stepped care approach, and (5) reduce stigma.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

Notes

  1. The discussion of animal hoarding and/or squalor is beyond the scope of the current review; please see [21, 22].

References and Recommended Reading

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 5th ed. Washington: American Psychiatric Association; 2013.

    Book  Google Scholar 

  2. Nordsletten AE, Reichenberg A, Hatch SL, Fernandez dela Cruz L, Pertusa A, Hotopf M, et al. Epidemiology of hoarding disorder. Br J Psychiatry. 2013;203(6):445–52. This investigation sought to enhance the accuracy of prevalence estimates for hoarding disorder (HD) by applying the DSM-5 diagnostic criteria during in-home, face-to-face interviews with a diverse community sample. The weighted prevalence was 1.5%, lower than estimates from previous studies. Prevalence rates were greater for older adults and similar between male and female clients. Characterizing the population of persons with hoarding disorder may enhance the identification and treatment of hoarding.

    Article  PubMed  Google Scholar 

  3. Timpano KR, Exner C, Keshaviah A, Rief W, Brähler E, Wilhelm S. The epidemiology of the proposed hoarding disorder: exploration of the acquiring specifier, associated features, and distress. J Clin Psychiatry. 2011;72(6):780–6.

    Article  PubMed  Google Scholar 

  4. Frost RO, Steketee G, Tolin DF. Comorbidity in hoarding disorder. FOCUS. 2015;13(2):244–51.

    Article  Google Scholar 

  5. Steketee G, Frost RO. Phenomenology of hoarding. In: Frost RO, Steketee G, editors. The Oxford handbook of hoarding and acquiring. New York: Oxford University Press; 2014. p. 19–32.

    Google Scholar 

  6. Rodriguez CI, Herman D, Alcon J, Chen S, Tannen A, Essock S, et al. Prevalence of hoarding disorder in individuals at potential risk of eviction in New York City: a pilot study. J Nerv Ment Dis. 2012;200(1):91–4.

    Article  PubMed  Google Scholar 

  7. Tolin DF, Frost RO, Steketee G, Gray KD, Fitch KE. The economic and social burden of compulsive hoarding. Psychiatry Res. 2008;160(2):200–11.

    Article  PubMed  PubMed Central  Google Scholar 

  8. Wilbram M, Kellett S, Beail N. Compulsive hoarding: a qualitative investigation of partner and carer perspectives. Br J Clin Psychol. 2008;47(1):59–73.

    Article  PubMed  Google Scholar 

  9. Drury H, Ajmi S, Fernández dela Cruz L, Nordsletten AE, Mataix-Cols D. Caregiver burden, family accommodation, health, and well-being in relatives of individuals with hoarding disorder. J Affect Disord. 2014;159:7–14.

    Article  PubMed  Google Scholar 

  10. Tolin DF, Frost RO, Steketee G, Fitch KE. Family burden of compulsive hoarding: results of an internet survey. Behav Res Ther. 2008;46(3):334–44.

    Article  PubMed  PubMed Central  Google Scholar 

  11. Polak KC, Levy JK, Crawford PC, Leutenegger CM, Moriello KA. Infectious diseases in large-scale cat hoarding investigations. Vet J. 2014;201(2):189–95.

    Article  CAS  PubMed  Google Scholar 

  12. Hoarding of Animals Research Consortium. Health implications of animal hoarding. Health Soc Work. 2002;27(2):125–36.

    Article  Google Scholar 

  13. Dong XQ, Simon MA, Mosqueda L, Evans DA. The prevalence of elder self-neglect in a community-dwelling population: hoarding, hygiene, and environmental hazards. J Aging Health. 2011;0898264311425597.

  14. Bratiotis C, Woody SR. Community interventions for hoarding. In: Frost RO, Steketee G, editors. The Oxford handbook of hoarding and acquiring. New York: Oxford University Press; 2014. p. 316–28.

    Google Scholar 

  15. Hoarding SFTFoC. Beyond overwhelmed: the impact of compulsive hoarding and cluttering in San Francisco and recommendations to reduce negative impacts and improve care. San Francisco, CA: Mental Health Association of San Francisco 2009

  16. Frost RO, Hartl TL. A cognitive-behavioral model of compulsive hoarding. Behav Res Ther. 1996;34(4):341–50.

    Article  CAS  PubMed  Google Scholar 

  17. Timpano KR, Broman-Fulks JJ, Glaesmer H, Exner C, Rief W, Olatunji BO, et al. A taxometric exploration of the latent structure of hoarding. Psychol Assess. 2013;25(1):194–203. This study conducted a taxometric analysis of hoarding symptoms and presents findings that suggest a dimensional latent structure (versus discrete categories of status as a disorder). Results support the existence of hoarding symptoms along a continuum and have significant implications for assessment, determination of treatment response, and the shaping of public policies.

    Article  PubMed  Google Scholar 

  18. Pertusa A, Fullana MA, Singh S, Alonso P, Menchon JM, Mataix-Cols D. Compulsive hoarding: OCD symptom, distinct clinical syndrome, or both? AJ Psychiatry. 2008;165(10):1289–98.

    Google Scholar 

  19. Frost RO, Patronek G, Rosenfield E. Comparison of object and animal hoarding. Depress Anxiety. 2011

  20. Snowdon J. Accumulating too much stuff: what is hoarding and what is not? Australasian Psychiat: Bull Royal Australian New Zealand College Psychiat. 2015;23(4):354–7.

    Article  Google Scholar 

  21. Norberg MM, Snowdon J. Severe domestic squalor. In: Frost RO, Steketee G, editors. The Oxford handbook of hoarding and acquiring. New York: Oxford University Press; 2014. p. 146–58.

    Google Scholar 

  22. Patronek GJ, Ayers CR. Animal hoarding. In: Frost RO, Steketee G, editors. The Oxford handbook of hoarding and acquiring. New York: Oxford University Press; 2014. p. 139–46.

    Google Scholar 

  23. Bulli F, Melli G, Carraresi C, Stopani E, Pertusa A, Frost RO. Hoarding behaviour in an Italian non-clinical sample. Behav Cogn Psychother. 2014;42(3):297–311.

    Article  PubMed  Google Scholar 

  24. Mueller A, Mitchell JE, Crosby RD, Glaesmer H, de Zwaan M. The prevalence of compulsive hoarding and its association with compulsive buying in a German population-based sample. Behav Res Ther. 2009;47(8):705–9.

    Article  PubMed  Google Scholar 

  25. Samuels JF, Bienvenu OJ, Grados MA, Cullen B, Riddle MA, Liang KY, et al. Prevalence and correlates of hoarding behavior in a community-based sample. Behav Res Ther. 2008;46(7):836–44.

    Article  PubMed  PubMed Central  Google Scholar 

  26. Tolin DF, Meunier SA, Frost RO, Steketee G. Course of compulsive hoarding and its relationship to life events. Depress Anxiety. 2010;27(9):829–38.

    Article  PubMed  Google Scholar 

  27. Grisham JR, Frost RO, Steketee G, Kim HJ, Hood S. Age of onset of compulsive hoarding. J Anxiety Disord. 2006;20(5):675–86.

    Article  PubMed  Google Scholar 

  28. Dozier ME, Porter B, Ayers CR. Age of onset and progression of hoarding symptoms in older adults with hoarding disorder. Aging & mental health. 2015:1-7. This report discusses the age of onset of hoarding symptoms as well as the worsening course of these symptoms over the lifespan. HD symptoms emerged between 10-20 years old, while the onset of possible HD diagnosis was between 20-30 years-old. Approximately, 23 % reported an onset of HD symptoms after 40 years-old. These findings have implications for treatment

  29. Mataix-Cols D, Frost RO, Pertusa A, Clark LA, Saxena S, Leckman JF, et al. Hoarding disorder: a new diagnosis for DSM-V? Depress Anxiety. 2010;27(6):556–72.

    Article  PubMed  Google Scholar 

  30. Stein DJ, Phillips KA, Bolton D, Fulford KW, Sadler JZ, Kendler KS. What is a mental/psychiatric disorder? From DSM-IV to DSM-V. Psychol Med. 2010:1-7

  31. Pertusa A, Frost RO, Fullana MA, Samuels JF, Steketee G, Tolin DF, et al. Refining the diagnostic boundaries of compulsive hoarding: a critical review. Clin Psychol Rev. 2010;30(4):371–86.

    Article  PubMed  Google Scholar 

  32. Stein DJ, Kogan CS, Atmaca M, Fineberg NA, Fontenelle LF, Grant JE, et al. The classification of obsessive-compulsive and related disorders in the ICD-11. J Affect Disord. 2016;190:663–74.

    Article  CAS  PubMed  Google Scholar 

  33. Frost RO, Steketee G, Tolin DF. Diagnosis and assessment of hoarding disorder. Annu Rev Clin Psychol. 2012;8:219–42.

    Article  PubMed  Google Scholar 

  34. Frost RO, Tolin DF, Steketee G, Fitch KE, Selbo-Bruns A. Excessive acquisition in hoarding. J Anxiety Disord. 2009;23(5):632–9.

    Article  PubMed  PubMed Central  Google Scholar 

  35. Mataix-Cols D, Billotti D, Fernandez dela Cruz L, Nordsletten AE. The London field trial for hoarding disorder. Psychol Med. 2013;43(4):837–47.

    Article  CAS  PubMed  Google Scholar 

  36. Frost RO, Hristova V, Steketee G, Tolin DF. Activities of daily living scale in hoarding disorder. J Obsessive Compuls Relat Disord. 2013;2(2):85–90.

    Article  PubMed  Google Scholar 

  37. Frost RO, Tolin DF, Maltby N. Insight-related challenges in the treatment of hoarding. Cogn Behav Pract. 2010;17(4):404–13.

    Article  Google Scholar 

  38. Tolin DF, Fitch KE, Frost RO, Steketee G. Family informants’ perception of insight in compulsive hoarding. Cogn Ther Res. 2010;34:69–81.

    Article  Google Scholar 

  39. Edsell-Vetter J, Davis TH. Rethinking hoarding intervention: MBHP’s analysis of the hoarding intervention and tenancy preservation project. Boston: Metropolitan Boston Housing Partnership; 2015.

    Google Scholar 

  40. Mataix-Cols D, de la Cruz LF, Nakao T, Pertusa A. Testing the validity and acceptability of the diagnostic criteria for hoarding disorder: a DSM-5 survey. Psychol Med. 2011:1-10

  41. Drury H, Nordsletten AE, Ajmi S, Fernández dela Cruz L, Mataix-Cols D. Accuracy of self and informant reports of symptom severity and insight in hoarding disorder. J Obsessive-Compul Related Disorders. 2015;5:37–42.

    Article  Google Scholar 

  42. Nordsletten AE, Fernández dela Cruz L, Pertusa A, Reichenberg A, Hatch SL, Mataix-Cols D. The Structured Interview for Hoarding Disorder (SIHD): development, usage and further validation. J Obsessive-Compulsive Related Disorders. 2013;2(3):346–50.

    Article  Google Scholar 

  43. Frost RO, Steketee G, Grisham JR. Measurement of compulsive hoarding: Saving Inventory-Revised. Behav Res Ther. 2004;42(10):1163–82.

    Article  PubMed  Google Scholar 

  44. Storch EA, Muroff J, Lewin AB, Geller D, Ross A, McCarthy K, et al. Development and preliminary psychometric evaluation of the Children’s Saving Inventory. Child Psychiatry Hum Dev. 2011;42(2):166–82.

    Article  PubMed  Google Scholar 

  45. Tolin DF, Frost RO, Steketee G. A brief interview for assessing compulsive hoarding: the Hoarding Rating Scale-Interview. Psychiatry Res. 2010;30(1):147–52.

    Article  Google Scholar 

  46. Frost RO, Steketee G, Tolin DF, Renaud S. Development and validation of the Clutter Image Rating. J Psychopathol Behav Assess. 2008;3:193–203.

    Article  Google Scholar 

  47. Dozier ME, Ayers CR. Validation of the Clutter Image Rating in older adults with hoarding disorder. Int Psychogeriatr. 2015;27(5):769–76.

    Article  PubMed  Google Scholar 

  48. Fernandez de la Cruz L, Nordsletten AE, Billotti D, Mataix-Cols D. Photograph-aided assessment of clutter in hoarding disorder: is a picture worth a thousand words? Depress Anxiety. 2013;30(1):61–6.

    Article  PubMed  Google Scholar 

  49. Grisham JR, Williams AD. Assessing hoarding and related phenomena. In: Frost RO, Steketee G, editors. The Oxford handbook of hoarding and acquiring. New York: Oxford University Press; 2014. p. 235–46.

    Google Scholar 

  50. Kyrios M. Psychological models of hoarding. In: Frost RO, Steketee G, editors. The Oxford handbook of hoarding and acquiring. Oxford University Press: New York; 2014. p. 206–20.

    Google Scholar 

  51. Hirschtritt ME, Mathews CA. Genetics and family models of hoarding disorder. In: Frost RO, Steketee G, editors. The Oxford handbook of hoarding and acquiring. New York: Oxford University Press; 2014. p. 159–76.

    Google Scholar 

  52. Iervolino AC, Perroud N, Fullana MA, Guipponi M, Cherkas L, Collier DA, et al. Prevalence and heritability of compulsive hoarding: a twin study. AJ Psychiatry. 2009;166(10):1156–61.

    Google Scholar 

  53. Ivanov VZ, Mataix-Cols D, Serlachius E, Lichtenstein P, Anckarsäter H, Chang Z, et al. Prevalence, comorbidity and heritability of hoarding symptoms in adolescence: a population based twin study in 15-year olds. PLoS ONE. 2013;8(7):e69140.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  54. Hartl TL, Duffany SR, Allen GJ, Steketee G, Frost RO. Relationships among compulsive hoarding, trauma, and attention-deficit/hyperactivity disorder. Behav Res Ther. 2005;43(2):269–76.

    Article  PubMed  Google Scholar 

  55. Cromer KR, Schmidt NB, Murphy DL. Do traumatic events influence the clinical expression of compulsive hoarding? Behav Res Ther. 2007;45(11):2581–92.

    Article  PubMed  Google Scholar 

  56. Landau D, Iervolino AC, Pertusa A, Santo S, Singh S, Mataix-Cols D. Stressful life events and material deprivation in hoarding disorder. J Anxiety Disord. 2011;25(2):192–202.

    Article  PubMed  Google Scholar 

  57. Frost RO, Tolin DF, Steketee G, Oh M. Indecisiveness and hoarding. Int J Cognitive Therapy. 2011;4(3):253–62.

    Article  Google Scholar 

  58. Timpano KR, Rasmussen J, Exner C, Rief W, Schmidt NB, Wilhelm S. Hoarding and the multi-faceted construct of impulsivity: a cross-cultural investigation. J Psychiatr Res. 2013;47(3):363–70.

    Article  PubMed  Google Scholar 

  59. Grisham JR, Brown TA, Savage CR, Steketee G, Barlow DH. Neuropsychological impairment associated with compulsive hoarding. Behav Res Ther. 2007;45(7):1471–83.

    Article  PubMed  Google Scholar 

  60. Tolin DF, Villavicencio A, Umbach A, Kurtz MM. Neuropsychological functioning in hoarding disorder. Psychiatry Res. 2011

  61. Woody SR, Kellman-McFarlane K, Welsted A. Review of cognitive performance in hoarding disorder. Clin Psychol Rev. 2014;34(4):324–36.

    Article  PubMed  Google Scholar 

  62. Timpano KR, Schmidt NB. The relationship between self-control deficits and hoarding: a multimethod investigation across three samples. J Abnorm Psychol. 2013;122(1):13–25.

    Article  PubMed  Google Scholar 

  63. Slyne K, Tolin DF. The neurobiology of hoarding disorder. In: Frost RO, Steketee G, editors. The Oxford handbook of hoarding and acquiring. New York: Oxford University Press; 2014. p. 177–86.

    Google Scholar 

  64. Tolin DF, Stevens MC, Villavicencio AL, Norberg MM, Calhoun VD, Frost RO, et al. Neural mechanisms of decision making in hoarding disorder. Arch Gen Psychiatry. 2012;69(8):832–41.

    Article  PubMed  PubMed Central  Google Scholar 

  65. Tolin DF, Kiehl KA, Worhunsky P, Book GA, Maltby N. An exploratory study of the neural mechanisms of decision making in compulsive hoarding. Psychol Med. 2009;39(2):325–36.

    Article  CAS  PubMed  Google Scholar 

  66. Mataix-Cols D, Wooderson S, Lawrence N, Brammer MJ, Speckens A, Phillips ML. Distinct neural correlates of washing, checking, and hoarding symptom dimensions in obsessive-compulsive disorder. Arch Gen Psychiatry. 2004;61(6):564–76.

    Article  PubMed  Google Scholar 

  67. Saxena S, Brody AL, Maidment KM, Smith EC, Zohrabi N, Katz E, et al. Cerebral glucose metabolism in obsessive-compulsive hoarding. AJ Psychiatry. 2004;161(6):1038–48.

    Google Scholar 

  68. Steketee G, Frost RO, Kyrios M. Cognitive aspects of compulsive hoarding. Cogn Ther Res. 2003;27:463–79.

    Article  Google Scholar 

  69. Timpano KR, Shaw AM. Conferring humanness: the role of anthropomorphism in hoarding. Personal Individ Differ. 2013;54(3):383–8.

    Article  Google Scholar 

  70. Steketee G, Frost RO. Compulsive hoarding: current status of the research. Clin Psychol Rev. 2003;23(7):905–27.

    Article  PubMed  Google Scholar 

  71. Timpano KR, Shaw AM, Cougle JR, Fitch KE. A multifaceted assessment of emotional tolerance and intensity in hoarding. Behav Ther. 2014;45(5):690–9.

    Article  PubMed  Google Scholar 

  72. Shaw AM, Timpano KR, Steketee G, Tolin DF, Frost RO. Hoarding and emotional reactivity: the link between negative emotional reactions and hoarding symptomatology. J Psychiatr Res. 2015;63:84–90.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  73. Fernandez de la Cruz L, Landau D, Iervolino AC, Santo S, Pertusa A, Singh S, et al. Experiential avoidance and emotion regulation difficulties in hoarding disorder. J Anxiety Disord. 2013;27(2):204–9.

    Article  PubMed  Google Scholar 

  74. Ayers CR, Najmi S, Mayes TL, Dozier ME. Hoarding disorder in older adulthood. Am J Geriatr Psychiatry. 2015;23(4):416–22.

    Article  PubMed  Google Scholar 

  75. Storch EA, Lack CW, Merlo LJ, Geffken GR, Jacob ML, Murphy TK, et al. Clinical features of children and adolescents with obsessive-compulsive disorder and hoarding symptoms. Compr Psychiatry. 2007;48(4):313–8.

    Article  PubMed  Google Scholar 

  76. Timpano KR, Cek D, Fu ZF, Tang T, Wang JP, Chasson GS. A consideration of hoarding disorder symptoms in China. Compr Psychiatry. 2015;57:36–45.

    Article  PubMed  Google Scholar 

  77. Abramowitz JS, Franklin ME, Schwartz SA, Furr JM. Symptom presentation and outcome of cognitive-behavioral therapy for obsessive-compulsive disorder. J Consult Clin Psychol. 2003;71(6):1049–57.

    Article  PubMed  Google Scholar 

  78. Bloch MH, Bartley CA, Zipperer L, Jakubovski E, Landeros-Weisenberger A, Pittenger C, et al. Meta-analysis: hoarding symptoms associated with poor treatment outcome in obsessive-compulsive disorder. Mol Psychiatry. 2014;19(9):1025–30.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  79. Steketee G, Frost RO. Compulsive hoarding and acquiring: a therapist guide. Treatments that work. New York: Oxford University Press; 2007.

    Google Scholar 

  80. Steketee G, Frost RO. Compulsive hoarding and acquiring: workbook. Treatments that work. New York: Oxford University Press; 2007.

    Google Scholar 

  81. Muroff J, Underwood P. Treatment of an adult with hoarding disorder. Clinical handbook of obsessive-compulsive and related disorders. Springer; 2016. p. 241–58

  82. Tolin DF, Frost RO, Steketee G. An open trial of cognitive-behavioral therapy for compulsive hoarding. Behav Res Ther. 2007;45(7):1461–70.

    Article  PubMed  PubMed Central  Google Scholar 

  83. Steketee G, Frost RO, Tolin DF, Rasmussen J, Brown TA. Waitlist-controlled trial of cognitive behavior therapy for hoarding disorder. Depress Anxiety. 2010;27(5):476–84.

    Article  PubMed  PubMed Central  Google Scholar 

  84. Muroff J, Steketee G, Frost RO, Tolin DF. Cognitive behavior therapy for hoarding disorder: follow-up findings and predictors of outcome. Depress Anxiety. 2014;31(12):964–71. This article is one of few articles including follow-up data for CBT for hoarding. It presents findings on the follow-up period, after an RCT testing a 26-session individualized CBT for hoarding. Follow-up data show stability of gains but little additional improvement. Findings also suggest that gender, perfectionism, and social anxiety may be associated with worse outcomes.

    Article  PubMed  Google Scholar 

  85. Turner K, Steketee G, Nauth L. Treating elders with compulsive hoarding: a pilot program. Cogn Behav Pract. 2010;17(4):449–57.

    Article  Google Scholar 

  86. Ayers CR, Wetherell JL, Golshan S, Saxena S. Cognitive-behavioral therapy for geriatric compulsive hoarding. Behav Res Ther. 2011;49(10):689–94.

    Article  PubMed  PubMed Central  Google Scholar 

  87. Ayers CR, Saxena S, Espejo E, Twamley EW, Granholm E, Wetherell JL. Novel treatment for geriatric hoarding disorder: an open trial of cognitive rehabilitation paired with behavior therapy. Am J Geriatr Psychiatry. 2014;22(3):248–52.

    Article  PubMed  Google Scholar 

  88. Steketee G, Frost RO, Wincze J, Greene K, Douglass H. Group and individual treatment of compulsive hoarding: a pilot study. Behav Cogn Psychother. 2000;28:259–68.

    Article  Google Scholar 

  89. Muroff J, Steketee G, Rasmussen J, Gibson A, Bratiotis C, Sorrentino C. Group cognitive and behavioral treatment for compulsive hoarding: a preliminary trial. Depress Anxiety. 2009;26(7):634–40.

    Article  PubMed  Google Scholar 

  90. Gilliam CM, Norberg MM, Villavicencio A, Morrison S, Hannan SE, Tolin DF. Group cognitive-behavioral therapy for hoarding disorder: an open trial. Behav Res Ther. 2011;49(11):802–7.

    Article  PubMed  Google Scholar 

  91. Schmalisch CS, Bratiotis C, Muroff J. Processes in group cognitive and behavioral treatment for hoarding. Cogn Behav Pract. 2010;17(4):414–25.

    Article  Google Scholar 

  92. Tolin DF, Frost RO, Steketee G. Buried in treasures: help for compulsive acquiring, saving, and hoarding. Oxford: Oxford University Press; 2013

  93. Frost RO, Pekareva-Kochergina A, Maxner S. The effectiveness of a biblio-based support group for hoarding disorder. Behav Res Ther. 2011;49(10):628–34.

    Article  PubMed  Google Scholar 

  94. Frost RO, Ruby D, Shuer LJ. The Buried in Treasures Workshop: waitlist control trial of facilitated support groups for hoarding. Behav Res Ther. 2012;50(11):661–7.

    Article  PubMed  PubMed Central  Google Scholar 

  95. Muroff J, Steketee G, Bratiotis C, Ross A. Group cognitive and behavioral therapy and bibliotherapy for hoarding: a pilot trial. Depress Anxiety. 2012;29(7):597–604.

    Article  PubMed  Google Scholar 

  96. Muroff J, Bratiotis C, Steketee G. Treatment for hoarding behaviors: a review of the evidence. Clin Soc Work J. 2011;39(4):406–23.

    Article  Google Scholar 

  97. Tolin DF, Frost RO, Steketee G, Muroff J. Cognitive behavioral therapy for hoarding disorder: a meta-analysis. Depress Anxiety. 2015;32(3):158–66. This meta analytic paper demonstrated that specialized CBT for hoarding disorder (HD) is associated with significant reductions in hoarding symptoms and a large effect size, specifically for the core feature of difficulty discarding. However, the majority of clients still have HD symptoms after treatment. A greater number of treatment sessions and home visits were associated with more improvement in clinical outcomes. These findings have implications for future enhancements of hoarding treatment.

    Article  PubMed  Google Scholar 

  98. Moulding R, Nedeljkovic M, Kyrios M, Osborne D, Mogan C. Short-term cognitive-behavioural group treatment for hoarding disorder: a naturalistic treatment outcome study. Clin Psychol Psychother. 2016

  99. Mathews CA, Uhm S, Chan J, Gause M, Franklin J, Plumadore J, et al. Treating hoarding disorder in a real-world setting: results from the Mental Health Association of San Francisco. Psychiatry Res. 2016;237:331–8.

    Article  PubMed  Google Scholar 

  100. Saxena S, Brody AL, Maidment KM, Baxter Jr LR. Paroxetine treatment of compulsive hoarding. J Psychiatr Res. 2007;41(6):481–7.

    Article  PubMed  Google Scholar 

  101. Saxena S, Sumner J. Venlafaxine extended-release treatment of hoarding disorder. Int Clin Psychopharmacol. 2014;29(5):266–73.

    Article  PubMed  PubMed Central  Google Scholar 

  102. Harrison CL, Ferrier N, Young AH. Tolerability of high-dose venlafaxine in depressed patients. J Psychopharmacol (Oxford, England). 2004;18(2):200–4.

    Article  CAS  Google Scholar 

  103. Pittenger C, Kelmendi B, Wasylink S, Bloch MH, Coric V. Riluzole augmentation in treatment-refractory obsessive-compulsive disorder: a series of 13 cases, with long-term follow-up. J Clin Psychopharmacol. 2008;28(3):363–7.

    Article  PubMed  Google Scholar 

  104. Rodriguez CI, Bender Jr J, Marcus SM, Snape M, Rynn M, Simpson HB. Minocycline augmentation of pharmacotherapy in obsessive-compulsive disorder: an open-label trial. J Clin Psychiatry. 2010;71(9):1247–9.

    Article  PubMed  PubMed Central  Google Scholar 

  105. Rodriguez CI, Bender J, Morrison S, Mehendru R, Tolin DF, Simpson HB. Does extended release methylphenidate help adults with hoarding disorder? A case series. J Clin Psychopharmacol. 2013;33(3):444–7.

    Article  PubMed  PubMed Central  Google Scholar 

  106. Tompkins MA, Hartl TL. Family interventions for hoarding. In: Frost RO, Steketee G, editors. The Oxford handbook of hoarding and acquiring. New York: Oxford University Press; 2014. p. 303–15.

    Google Scholar 

  107. Tompkins MA, Hartl TL. Digging out: helping your loved one manage clutter, hoarding, and compulsive acquiring. New Harbinger Publications; 2009

  108. Logan DE, Marlatt GA. Harm reduction therapy: a practice-friendly review of research. J Clin Psychol. 2010;66(2):201–14.

    PubMed  PubMed Central  Google Scholar 

  109. Tompkins MA. Clinician’s guide to severe hoarding: a harm reduction approach. Springer; 2014

  110. Tompkins MA. Working with families of people who hoard: a harm reduction approach. J Clin Psychol. 2011;67(5):497–506.

    Article  PubMed  Google Scholar 

  111. Bratiotis C, Schmalisch CS, Steketee G. The hoarding handbook: a guide for human service professionals. Oxford: Oxford University Press; 2011

  112. Bratiotis C. Community hoarding task forces: a comparative case study of five task forces in the United States. Health Social Care Comm. 2013;21(3):245–53.

    Article  Google Scholar 

  113. Tompkins MA. Harm reduction process for severe hoarding. Clinician’s guide to severe hoarding. Springer; 2015. pp. 59–88.

  114. Edsell-Vetter J, Davis TH. New approach to hoarding intervention: preliminary data from the first three years of Hoarding Intervention and Tenancy Preservation Project. Boston: Metropolitan Boston Housing Partnership; 2014.

    Google Scholar 

  115. Muroff J, Steketee G, Himle J, Frost RO. Delivery of internet treatment for compulsive hoarding (D.I.T.C.H.). Behav Res Ther. 2009.

Download references

Author information

Authors and Affiliations

  1. Department of Psychology, University of Miami, 5665 Ponce de Leon Blvd, Coral Gables, FL, 33146, USA

    Kiara R. Timpano PhD

  2. School of Social Work, Boston University, 264 Bay State Road, Boston, MA, 02215, USA

    Jordana Muroff PhD, MSW & Gail Steketee PhD

Authors
  1. Kiara R. Timpano PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Jordana Muroff PhD, MSW
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Gail Steketee PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Kiara R. Timpano PhD.

Ethics declarations

Conflict of Interest

Kiara Timpano, Jordana Muroff, and Gail Steketee declare that they have no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

Additional information

This article is part of the Topical Collection on Anxiety, Obsessive Compulsive and Related Disorders

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Timpano, K.R., Muroff, J. & Steketee, G. A Review of the Diagnosis and Management of Hoarding Disorder. Curr Treat Options Psych 3, 394–410 (2016). https://doi.org/10.1007/s40501-016-0098-1

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s40501-016-0098-1

Keywords

Search

Navigation