Diagnosis of hoarding

NewsGuard 100/100 Score

Compulsive hoarding is a progressive disease. Diagnosis, like in other mental health conditions, is not straightforward.

There are people who hoard but are not compulsive hoarders. These individuals need to be identified when diagnosing the condition.

However, these hoarders over years and after a traumatic life event like a bereavement of depressive episode may turn into compulsive hoarders. (1)

Hoarders often do not realise they have a problem

Most people with compulsive hoarding do not realise they have a problem and seldom seek help.

It may be only family and friends who report with the problem.

Compulsive hoarders often do not understand that by refusing to part with their possessions they are hindering their own life.

Other psychiatric conditions associated with hoarding

There may also be other psychiatric conditions with hoarding like:

  • Major depression
  • General anxiety disorder
  • Social phobia
  • Post-traumatic stress disorder (PTSD)
  • Attention Deficit Hyperactivity Disorder (ADHD)
  • Grooming disorders (Trichotillomania or tearing off one’s own hair, skin picking, nail biting)
  • Dementia. (1)

This additionally makes diagnosing and treating compulsive hoarders a challenge.

DSM V classification

Hoarding in its compulsive form is being considered for inclusion in DSM V as a distinct disorder called “Hoarding Disorder”.

The DSM is the Diagnostic and Statistical Manual of Mental disorders.

The current version is the fourth and the fifth version is expected in a year.

Earlier compulsive hoarding was a part of obsessive compulsive disorders or OCD. (2)

Diagnosis should begin with a thorough assessment of patients' history and clinical presentation. (3)

Thus diagnosing compulsive hoarding involves certain diagnostic criteria in DSM V. These are proposed include (2) –

  • Continued difficulty in discarding or parting with personal possessions even those which are useless. This is due to strong urges to save items and distress and indecision associated with getting rid of stuff.
  • The symptoms result in collection of large number of possessions that fill up and encroach on living space.
  • There may be clinically significant distress and impairment of social, occupational, or other important areas of daily living.
  • The hoarding is not explained by other conditions like stroke or brain injury.
  • Hoarding not restricted to the symptoms of other mental ailments like OCD, depressive illness, schizophrenia, dementia, autism etc.
  • In addition there may be excessive acquisition by buying, stealing or scavenging, lack of awareness that there is a problem or a delusion that the behavior is not worrisome.

Assessment of hoarders

Assessment includes (3) –

  • Looking at the amount of clutter
  • Assessment of beliefs about possessions
  • Assessment of information processing, decision making and categorizing difficulties among sufferers
  • Avoidance behavior assessment - compulsive hoarders may avoid routine tasks such as checking mail, returning calls, or washing dishes or social obligations like paying bills, rent, and taxes
  • Assessment of daily functioning like sleep wake cycles, daily routines etc.
  • Assessment of regular and daily intake of medications and willingness to adhere to regular therapy
  • Assessment of work place and social functioning and interactions
  • Assessment for other mental ailments like depression, anxiety and specific phobias

Scales to assess hoarding

Scales used to assess hoarding include (3, 4) –

  • Saving Inventory-Revised (SIR) scale – This is a 23-item questionnaire that asks about three features of hoarding that include - excessive acquisition, difficulty discarding, and clutter.
  • Hoarding Rating Scale (HRS) – This is a 5-item interview that can be given to a suspected sufferer as a questionnaire.

    The questions ask about clutter, difficulty discarding, excessive acquisition, distress caused by hoarding and impairment resulting from it.

    Studies show that a score of 14 or higher indicates a probable hoarding problem.

  • Clutter Image Rating (CIR) – In this a series of pictures of rooms in various stages of clutter – from completely clutter-free to very severely cluttered are taken.

    The suspected sufferer is asked to pick out the picture in each sequence that resembles their own living room, kitchen, and bedroom the closest.

Further Reading

Last Updated: Jun 4, 2019

Dr. Ananya Mandal

Written by

Dr. Ananya Mandal

Dr. Ananya Mandal is a doctor by profession, lecturer by vocation and a medical writer by passion. She specialized in Clinical Pharmacology after her bachelor's (MBBS). For her, health communication is not just writing complicated reviews for professionals but making medical knowledge understandable and available to the general public as well.


Please use one of the following formats to cite this article in your essay, paper or report:

  • APA

    Mandal, Ananya. (2019, June 04). Diagnosis of hoarding. News-Medical. Retrieved on April 14, 2024 from https://www.news-medical.net/health/Diagnosis-of-hoarding.aspx.

  • MLA

    Mandal, Ananya. "Diagnosis of hoarding". News-Medical. 14 April 2024. <https://www.news-medical.net/health/Diagnosis-of-hoarding.aspx>.

  • Chicago

    Mandal, Ananya. "Diagnosis of hoarding". News-Medical. https://www.news-medical.net/health/Diagnosis-of-hoarding.aspx. (accessed April 14, 2024).

  • Harvard

    Mandal, Ananya. 2019. Diagnosis of hoarding. News-Medical, viewed 14 April 2024, https://www.news-medical.net/health/Diagnosis-of-hoarding.aspx.


The opinions expressed here are the views of the writer and do not necessarily reflect the views and opinions of News Medical.
Post a new comment

While we only use edited and approved content for Azthena answers, it may on occasions provide incorrect responses. Please confirm any data provided with the related suppliers or authors. We do not provide medical advice, if you search for medical information you must always consult a medical professional before acting on any information provided.

Your questions, but not your email details will be shared with OpenAI and retained for 30 days in accordance with their privacy principles.

Please do not ask questions that use sensitive or confidential information.

Read the full Terms & Conditions.