IS HOARDING A NORMAL PHENOMENON, PERSONALITY DEFORMITY, OR A MENTAL DISORDER

Hoarding behavior is a normal phenomenon commonly observed in all corners of the world to prevent future scarcity of resources and overcome challenges of survival. Hoarding signs typically develop in childhood or early adolescence, which may become a serious disorder in the late phase of life. At present, hoarding disorder has been covered under the chapter of ‘Obsessive-Compulsive and Related Disorders’ along with obsessive-compulsive disorder, body dysmorphic disorder, trichotillomania (hair-pulling disorder), and excoriation (skin-picking) disorder as per DSM-5. Hoarding disorder (HD) is defined as a persistent difficulty discarding possessions, resulting in an accumulation of belongings, causing severe clutter and the congestion of living areas. HD appears to be a chronic problem that presents a burden on family and society. Pharmacotherapy of this disorder exhibits a gloomy picture since no approved allopathic medicines are available for its management. The best clinically proven way to manage hoarding disorder is with cognitive behavioral therapy, which motivates the patient specifically in addressing the key characteristics of this disorder. Recent lines of evidence suggest that hoarding disorder is therapeutical, neuro-biologically, socially, and genetically a personality disorder distinct from anxiety as well as obsessive-compulsive disorder. This review article depicts with the help of a diagram how HD is different from normal collecting/hoarding behavior. The hoarding disorder may be looked upon as an extension of the normal collecting (hoarding) phenomenon, which not only becomes a personality deformity but presents a dangerous clinical picture in elderly individuals complicated by the presence of other psychiatric co-morbidities.