Advances in Psychiatric Treatment (2009) 15: 344-353. doi: 10.1192/apt.bp.107.005215
© 2009 The Royal College of Psychiatrists
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Hoarding behaviour: building up the ‘R factor’{dagger}

Romina Lopez Gaston, Farida Kiran-Imran, Fairooz Hassiem and John Vaughan

This article was written while the authors were working in Malvern Community Mental Health Team, Worcestershire Mental Health Partnership Trust. Romina Lopez Gaston is a specialist registrar in adult psychiatry with a clinical interest in liaison psychiatry and substance misuse. Farida Kiran-Imran is a CT1 core medical trainee. Fairooz Hassiem works as an associate specialist in old age psychiatry and her clinical research interest is focused on the interface of psychiatric disorders that affect older and younger adults. John Vaughan is a consultant psychiatrist particularly interested in psychological interventions.

Correspondence: Correspondence Dr Romina Lopez Gaston, Newbridge House, 130 Hobmoor Road, Small Heath, Birmingham B10 9JH, UK. Email: logaston1{at}hotmail.com

Hoarding seems to be a non-specific symptom, as it has been associated with a wide range of psychiatric disorders. Validating hoarding as pathological is controversial and its nosological status remains unresolved. ‘Diogenes syndrome’ has been paradigmatic in this area, but its clinical use seems limited. Hoarding is not explicitly covered in either DSM–IV or ICD–10 and literature suggests that diagnosis of mental illness may consequently be missed in this population. In the context of these theoretical uncertainties, clinicians still need to accurately assess and treat patients who show hoarding behaviour. To this end, we summarise the available evidence, and present assessment and management algorithms together with a multicomponent psychological intervention that aims to teach patients to successfully apply the three Rs (reduce, recycle, reuse).


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