Compulsive Hoarding

Background: To present the rationale for the new Obsessive-Compulsive and Related Disorders (OCRD) grouping in the Mental and Behavioural Disorders chapter of the Eleventh
Revision of the World Health Organization’s International Classification of Diseases and Related Health Problems (ICD-11), including the conceptualization and essential features of disorders in this grouping.
Methods: Review of the recommendations of the ICD-11 Working Group on the Classification for OCRD. These sought to maximize scientific validity, clinical utility, and global
applicability.
Results: The rationale for the grouping is based on common clinical features of included disorders including repetitive unwanted thoughts and associated behaviours, and is supported by emerging evidence from imaging, neurochemical, and genetic studies. The proposed grouping includes obsessive-compulsive disorder, body dysmorphic disorder, hypochondriasis, olfactory reference disorder, and hoarding disorder. Body-focused repetitive behaviour disorders, including trichotillomania and excoriation disorder are also included. Tourette disorder, a neurological disorder in ICD-11, and personality disorder with anankastic features, a
personality disorder in ICD-11, are recommended for cross-referencing. Limitations: Alternative nosological conceptualizations have been described in the
literature and have some merit and empirical basis. However, the proposed ICD-11 OCRD grouping is most likely to achieve the goals of maximizing clinical utility and global applicability.
Conclusion: It is anticipated that creation of an OCRD grouping will contribute to accurate identification and appropriate treatment of affected patients as well as research efforts
aimed at improving our understanding of the prevalence, assessment, and management of its constituent disorders.

Accessible summaryIt is estimated that between 2% and 5% of the population experience symptoms of compulsive hoarding. Recent investigation into hoarding has shown that it is a problem in its own right and is therefore being added to a diagnostic manual of mental disorders.This integrative literature review examines the impact that hoarding has on family members.The comprehensive literature review spans a period from database inception to November 2012. A search of the databases Cumulative Index to Nursing and Allied Health Literature, Medical Literature Analysis and Retrieval System Online, and psycINFO, together with hand searches, was completed.Thematic analysis revealed three overriding themes: quality of life, shattered families and rallying around. These themes illuminate the negative impact that hoarding behaviour has on families and the inadequacy of available services.The relative lack of robust evidence about the impact of hoarding behaviour on families suggests that further research is needed in this emergent field.It is estimated that between 2% and 5% of the population experience symptoms of compulsive hoarding. Recent investigation into hoarding has shown that it is a problem in its own right and is therefore being added to a diagnostic manual of mental disorders.This integrative literature review examines the impact that hoarding has on family members.The comprehensive literature review spans a period from database inception to November 2012. A search of the databases Cumulative Index to Nursing and Allied Health Literature, Medical Literature Analysis and Retrieval System Online, and psycINFO, together with hand searches, was completed.Thematic analysis revealed three overriding themes: quality of life, shattered families and rallying around. These themes illuminate the negative impact that hoarding behaviour has on families and the inadequacy of available services.The relative lack of robust evidence about the impact of hoarding behaviour on families suggests that further research is needed in this emergent field.AbstractCompulsive hoarding affects approximately 2–5% of the adult population. Increasing recognition has led to its inclusion as a distinct condition in forthcoming revisions to the Diagnostic and Statistical Manual V. Hoarding behaviour can have a detrimental effect on the health and well-being of family members. A rigorous review of available evidence using a novel three-stage literature search was undertaken: (1) an extensive scoping review; (2) a traditional search of databases including Cumulative Index to Nursing and Allied Health Literature, Medical Literature Analysis and Retrieval System Online, and psycINFO using combinations of keywords; and (3) review of cited references and hand-searching of selected journals. Evidence was selected using predefined inclusion criteria. Papers included two surveys, one qualitative study and one case study. An integrative review methodology was used to synthesize the evidence presented. Analysis revealed three overriding themes: quality of life, shattered families and rallying around. These illuminated the experiences of family members. These papers revealed families under strain and often at breaking point but with the resolve to pull together if the right support is available. This review concludes that further research is needed to investigate the effects of hoarding on family members and how these may best be met.Compulsive hoarding affects approximately 2–5% of the adult population. Increasing recognition has led to its inclusion as a distinct condition in forthcoming revisions to the Diagnostic and Statistical Manual V. Hoarding behaviour can have a detrimental effect on the health and well-being of family members. A rigorous review of available evidence using a novel three-stage literature search was undertaken: (1) an extensive scoping review; (2) a traditional search of databases including Cumulative Index to Nursing and Allied Health Literature, Medical Literature Analysis and Retrieval System Online, and psycINFO using combinations of keywords; and (3) review of cited references and hand-searching of selected journals. Evidence was selected using predefined inclusion criteria. Papers included two surveys, one qualitative study and one case study. An integrative review methodology was used to synthesize the evidence presented. Analysis revealed three overriding themes: quality of life, shattered families and rallying around. These illuminated the experiences of family members. These papers revealed families under strain and often at breaking point but with the resolve to pull together if the right support is available. This review concludes that further research is needed to investigate the effects of hoarding on family members and how these may best be met.

Background and aims: The appetitive aspects of hoarding disorder, such as the compulsive acquisition and saving of objects, are akin to other behavioral addictions. Underpinning these appetitive features is the strong emotional and sentimental attachments that hoarding sufferers have for their possessions. Different facets of object attachment have been identified including anthropomorphism, insecure object attachment, possessions as an extension of identity, possessions as a repository of autobiographical memories, and possessions as a source of comfort and safety. The aim of this study was to examine the association between each of these facets and hoarding symptoms independent of non-sentimental hoarding beliefs, depression, and anxiety.

Methods: Participants were 532 individuals recruited via Turkprime who completed online self-report questionnaires on hoarding symptoms, hoarding beliefs, depression, anxiety, and the facets of object attachment. Pearson's correlations and hierarchical multiple regression analyses were conducted.

Results: The results showed that all facets of object attachment were positively correlated with hoarding symptoms. After accounting for other non-sentimental hoarding beliefs, depression, and anxiety, three facets made significant unique contributions to hoarding symptoms: insecure object attachment, anthropomorphism, and possessions as a repository of autobiographical memories.

Discussion and conclusions: Based on these findings, we propose a compensatory model to explain how the different facets of object attachment may be implicated in hoarding. Further research into ways of reducing anthropomorphism, insecure object attachment, and possessions as memories are warranted.

This study describes media and judicial reaction to the first publicly acknowledged case of animal hoarding in Sweden—a 60-year-old Swedish woman who purportedly " rescued " 150 swans over several years by bringing many back to her one-room apartment. Reports in the press and social media reflected curiosity if not admiration for this woman, who was dubbed the " Swan Lady. " Although some condemned her deeds and saw her as guilty of animal cruelty, most commentators were more fascinated by her ability to capture the aggressive and large birds, and bring them to her home. While judicial reaction framed this case as one of animal cruelty, the response was sympathetic and people failed to consider the Swan Lady's mental health when examining her behavior. Keywords animal rescue – swans – hoarding – cruelty to animals