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Where Do Hoarding Behaviors Belong When Classifying Mental Illness

Several years ago the popular television program about a San Francisco police detective named Adrian Monk drew compassionate attention to mental illness. Monk was an ace at detective work, but his obsessive-compulsive behavior prevented him from being able to function smoothly within the police force proper.

Obsessive behaviors don’t always interrupt life quite so dramatically, but they are a sign of mental health concerns, usually an anxiety disorder. The person with obsessive-compulsive disorder (OCD) experiences recurring thoughts which provoke him/her to behaviors which serve no rational purpose other than to allay the anxiety which the person feels.

The question as to whether hoarding is a subset of OCD or deserves a separate classification altogether is being considered by those currently responsible for updating the Diagnostic and Statistical Manual of Mental Health (DSM).

That manual guides mental health clinicians in assessing and treating patients by clearly outlining mental illnesses. Without a clear DSM diagnosis guide, clinicians must make subjective determinations and insurance providers sometimes refuse to cover treatment.

Hoarders are people driven by compulsions and the need to ward off anxiety in ways that are similar to those living with OCD. Persons who hoard feel compelled to accumulate items and do so to excess despite any negative physical or financial consequences. The hoarder’s attachment to these objects is so intense that to lose them in some way creates strong feelings of anxiousness.

One U.S. study on hoarding was recently highlighted on a therapy website. The study examined samples of adults and college students who exhibited hoarding behaviors. The study revealed that hoarders demonstrate a broad range of symptoms. If the behavior were to become a diagnosable condition, the researchers recommend using a sliding scale of moderate to severe manifestations rather than establishing one definite threshold.

While helpful in identifying the range of problem behaviors, the study failed to answer the question about whether or not obsessive object accumulation should fall within the same category as obsessive hand-washing and step counting. Look for the 2013 DSM to resolve the issue.

There is still hope.

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