Hoarders are mentally ill and need help

By Dr. Ananya Mandal, MDFeb 22 2012

According to experts people who are compulsive hoarders are ill with a serious mental disorder and need help. Hoarding is affecting between 400,000 and 1.1 million Australians, a conference in Sydney heard this week, and can affect more than just elderly people living alone. Yet it is only now gaining acceptance as a clinical condition with its inclusion this year in the Diagnostic and Statistical Manual of Mental Disorders.

It is characterized by excessive collecting and an extreme inability to discard worthless objects. Compulsive hoarders often live in squalor and risk disease, injury, fires and homelessness, and their over-attachment to things can compromise their relationships, clinical psychologist Dr Christopher Mogan says. An estimated one in four people in Melbourne who die in house fires are hoarders.

“To throw something away is to throw away part of themselves...it’s a very pervasive disease that's hard for the non-hoarder to grasp,” he told a conference in Sydney yesterday. The two-day forum, dubbed Pathways Through the Maze National Hoarding and Squalor conference, attracted 135 experts from Australia, the UK and the US.

According to Dr Mogan, compulsive hoarding disorder is five times more common than schizophrenia and twice as common as obsessive compulsive disorder (OCD). “Obsessive Compulsive Disorder is already the fourth most common mental disorder ... it's really a sleeping giant.”

“It does manifest itself in the older age group, but it's a chronic condition that starts at a very young age – as young as 10 or 12, and it gets worse during the 20s,” he said. “But most people don't get treated until they are over 50. It’s a chronic and ongoing condition.”

The answer to it is not simple. “A son or daughter going into a parent's house and doing a big clean up is definitely not the answer to a hoarding disorder,” warns Catholic Community Services director Annabel Senior. “All that will happen is that they will feel absolutely terrible that the stuff they want around them has been thrown away, and they'll go out and replace it. They'll start all over again.” Hoarders often suffer from depression, anxiety and social isolation she said.

Twenty years ago, compulsive hoarding disorder was regarded as a variation of OCD, Dr Mogan said. However, he would like to see it classified as a distinct disorder with its own criteria, research, therapies and training for specialists. “It's separate from OCD,” he said.
“The bible of psychiatric disorders is called the DSM,” he said. “It's bringing out a fifth edition next year and hoarding disorder has been recommended to be included for the first time in this manual. This will open up a whole lot of opportunities, by way of training workers, recognition in terms of  research grants, and it will bring it to the notice of people.”