OCD and Compulsive Hoarding

A illness in its own right?

Hoarding is not currently considered a illness in its own right.  Traditionally compulsive hoarding has been treated as symptom or subtype of Obsessive Compulsive Disorder (OCD), rather than a condition in itself.  

The DSM-IV (The Diagnostic and Statistical Manual of Mental Disorders) which was published in 1994 (text amendment in 2000) lists Compulsive Hoarding only as a symptom of OCD. The DSM-IV does not list hoarding behaviour in the diagnostic criterion of OCD.

However this is all due to change with DSM-V where hoarding disorder (compulsive hoarding) is expected to be defined as a discrete disorder rather than being a symptom of OCD. 

Much of the research carried out on compulsive hoarding is around the relationship between OCD and hoarding and new research has raised doubts about the OCD connection.

Researchers noticed that while some hoarding behaviours would respond to OCD treatments, many would not.  Even where a patient can be identified as having OCD and being a hoarder, the hoarding may or may not respond to the standard recommended treatments

Recent studies on OCD and compulsive hoarding

The most recent studies have identified two separate situations; OCD plus hoarding and compulsive hoarding on its own.  Other researchers are beginning to think that compulsive hoarding is almost always an independent condition but that it is often found in conjunction (co-morbidity) with other psychological disorders.

It also seems that hoarders with OCD tend to behave differently to clinical compulsive hoarders.   The perfectionist OCD hoarder arranges neatly ordered stacks, the piles are sorted, organised and perfectly aligned.  They more likely to hoard  'bizarre' items and feel a need to perform compulsions related to the items they hoard, such as checking or rituals.

There are strong moves to define Compulsive Hoarding as an separate disorder in the revision of the DSM (DSM-V) due in 2013.  This has tentatively been called 'Hoarding Disorder'.

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