A Review of the Diagnosis and Management of Hoarding Disorder

Opinion statementHoarding disorder (HD) is a severe psychiatric and public health problem characterized by extreme challenges with discarding possessions and severe acquisition resulting in excessive clutter that impairs daily functioning and may cause substantial health and safety risks. Over the past 20  years, research on HD has grown substantially and lead to its recent designation in the DSM-5 as a discrete disorder. The key features of the cognitive behavioral etiological model of hoarding include core vulnerabilities, information processing deficits, cognitions and meaning of possessions, and emotionally driven reinforcement patterns. This model has served as the theoretical foundation for efficacious, specialized cognitive behavioral treatment (CBT) for hoarding and validated hoarding assessment measures. The individual manualized CBT treatment has been adapted for delivery through var ious modalities (e.g., group, web-based, self-help), populations (e.g., geriatric), and providers (e.g., clinicians, peer support, case managers). While CBT is associated with significant reductions in hoarding severity, clinical levels of hoarding symptoms persist for greater than half of treatment completers; thus, more efficacious treatments need to be developed. Further research is necessary to elucidate components of the CBT model and their interaction, in order to inform treatment targets. Although research on pharmacological treatments for HD is in the nascent stages and extant ...

Source: Current Treatment Options in Psychiatry - October 12, 2016 Category: Psychiatry Source Type: research