Hoarding vs. OCD

Brief History of Hoarding

The concept of hoarding has been around for nearly a century with roots in the psychoanalytical realm. Freud characterized it has part of the "anal" stage, which was characterized as being withholding. It was believed that people with this anal personality were well on their way to developing obsessive-compulsive disorder (OCD), thus the anal retentive personality. Pieces of this anal retentive personality are currently found in the Obsessive-Compulsive Personality Disorder (OCPD) diagnosis in the DSM-5.

Differential Diagnosis

Obsessive Compulsive Personality Disorder (OCPD) is a style of relating that is characterized by orderliness and inflexibility. You might describe such people as "uptight" or "anal". The definition of OCPD does not necessarily fit most hoarding cases. According to the DSM-5, people with OCPD have an "inability to discard worn-out or worth less objects even when they have no sentimental value." However, hoarders seldom save only worthless and worn out things, they also save many items because of their emotional or sentimental value. For this reason it has been suggested that removing the hoarding criteria from the OCPD diagnosis would improve its validity.

Until recently, hoarding was considered a form of OCD. OCD is comorbid in 16-35% individuals with compulsive hoarding. While hoarding does seem to be related to OCD, a large number of people with hoarding problems do not display other OCD symptoms. One study showed that out of 217 hoarding patients, only 18% met diagnostic criteria for OCD and several other disorders were also present (Major Depressive Disorder 50%, Generalized Anxiety Disorder 24%, Social Phobia 24%).

What is the difference between Hoarding Disorder and OCD?

The thoughts that are associated with Hoarding Disorder and OCD are different:

OCD

• thoughts are intrusive and repetitive
• there is a compulsion to perform a ritual to gain control
• anxiety and distress accompany OCD
• OCD symptoms go through peaks and valleys
• OCD patients can be more insightful about the OCD symptoms

Hoarding

• thoughts are a part of person's everyday normal stream of thought
• thoughts are not repetitive
• thoughts are not distressing or unpleasant
• there is no urge to get rid of clutter
• no urge to perform a ritual to control the thoughts
• distress is brought on by the prospect of having to discard possessions
• hoarders experience positive emotions when they acquire objects
• grief is felt when an attempt is made to discard objects
• hoarders have less insight about their problem than do OCD patients

Learn more about clinial hoarding disorder.

Both hoarding disorder and OCD can be effectively treated with cognitive-behavioral therapy (CBT). Contact the New England OCD Institute for help.