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By Dr David Mataix-Cols, Ph.D.

Like most human behaviours, saving and collecting possessions can range from being totally normal to excessive or pathological. Most children have collections at some point and approximately 30% of British adults define themselves as collectors. Hoarding and Compulsive Hoarding are some of the more commonly used terms to refer to an excessive and problematic form of 'collectionism'.

Hoarding is highly prevalent (approximately 2-5% of the population – that is potentially between 1.3 – 3.3 million people in the UK alone) and when severe, is associated with substantial functional disability and represents a great burden for the sufferers, their families and society.

The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), the book which contains all officially recognised mental disorders, was published in 2013 and included a new diagnosis named "Hoarding Disorder." This diagnosis would apply to hoarding that occurs in the absence of, or independently from, other organic or mental disorders.

The World Health Organisation (WHO) announced recognition of Hoarding Disorder in 2018 in its International Classification of Diseases (ICD-11). Definition as follows: “Hoarding Disorder is characterised by accumulation of possessions due to excessive acquisition of, or difficulty discarding possessions, regardless of their actual value". It adds: "Accumulation of possessions results in living spaces becoming cluttered to the point that their use or safety is compromised. The symptoms result in significant distress or significant impairment in personal, family, social, educational, occupational or other important areas of functioning.“

It is worth noting that whilst some people who hoard have good insight into the problems caused by their behaviour, others are completely convinced that their situation is not problematic, despite evidence to the contrary. These sufferers are often reluctant to seek help for their problems, causing great distress to those close to them.

Dr David Mataix-Cols, PH.D, now lectures at the Karolinska Institute in Sweden.

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