It seems like hoarding is finally coming out of the closet and spilling across table tops, filling up spaces under the bed, and covering the hallways. Although there are now television shows about clutterers and hoarding, most mental health experts believe the condition still goes underreported and undertreated. Patients are often reluctant to talk about their situation, because of shame, but also sometimes from lack of insight into the problems caused by their hoarding.

For years hoarding was simply considered an aspect of either obsessivecompulsive personality disorder, or of obsessivecompulsive disorder (OCD). But in 2013 hoarding was officially declared a separate condition, after numerous studies failed to find much in common with basic OCD traits. Subsequent research has shown that ADHD, is the condition most closely associated with hoarding, in particular, inattentive ADHD traits. Hoarders also have depression and anxiety at higher rates that the general population.

Treatments for hoarding have not been extensively investigated. Cognitivebehavioral therapies remain the most frequently recommended treatment, often modified with Motivational Interviewing, Harm Reduction, Compassion Focused, and evolutionary psychology approaches. Peer support, often labeled a “clutter buddy”, or “body doubling” appears to be one of the most effective strategies for addressing hoarding. A few, very small studies suggest that SSRI, stimulants, and nonstimulant ADHD medications might provide benefit for some individuals.

References:

Elevated levels of hoarding in ADHD: A special link with inattention (2022)
https://www.sciencedirect.com/science...

Who really hoards? Hoarding symptoms in adults with attentiondeficit hyperactivity disorder (ADHD), obsessivecompulsive disorder (OCD) and healthy controls (2023)
https://www.sciencedirect.com/science...

Treating hoarding disorder with compassionfocused therapy: A pilot study examining treatment feasibility, acceptability, and exploring treatment effects (2020)
https://pubmed.ncbi.nlm.nih.gov/31271...

Hoarding Disorder and a Systematic Review of Treatment with Cognitive Behavioral Therapy (2016)
https://www.tandfonline.com/doi/full/...

Pharmacotherapy for Hoarding Disorder: How did the Picture Change since its Excision from OCD? (2019)
https://www.ncbi.nlm.nih.gov/pmc/arti...

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Psychiatrist, neuroscientist, and author John Kruse, MD, PhD presents practical, actionable, wellresearched information about treatment options that scientists and clinicians recommend for adult ADHD and other mental health conditions. Subscribe if you're curious about how neuroatypical brains can optimize their functioning in our shared, and somewhat strange, world.

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