There are no currently accepted diagnostic criteria for compulsive hoarding in the Diagnostic and Statistical Manual for Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR) (American Psychiatric Association, 2000). It is currently defined as having the following components:
- The client accumulates a large number of possessions that clutter the active living areas of the home (e.g., living room, kitchen, bedroom), workplace, or other personal surroundings (e.g., vehicle, yard) and are kept in a disorganized fashion.
- The client has current or past difficulty resisting the urge to collect, buy, or acquire free things that contribute to the clutter.
- The client is extremely reluctant to part with items, even those with very limited monetary value or utility
- The accumulation of clutter or difficulty parting with items causes marked distress or interferes significantly with normal use of the home, workplace, or other personal surroundings, occupational (or school) functioning, usual family and social activities; poses significant health or safety risks (e.g., blocked egress, cluttered stairs, fire hazard); or causes significant conflict with family members, neighbors, or authorities (e.g., work supervisors, landlord).
- The problem has persisted for at least six months and is not the result of a recent move, repairs to the home, the accumulation of many items resulting from the death of a family member, or other temporary circumstances.
- The clutter and the difficulty parting with items are not better accounted for by another mental disorder, or by the direct physiological effects of a substance (e.g., drug abuse, medication) or a general medical condition (e.g., stroke, brain injury).
It is most commonly considered to be a symptom of obsessive-compulsive disorder (OCD.) Along with difficulties in throwing things away, compulsive hoarders have severe difficulties with making decisions, perfectionism, and avoiding tasks. An estimated 700,000 to 1.4 million people in the United States are thought to have compulsive hoarding syndrome.