A Case of Coexisting Depression and Hoarding Disorder

Abstract

A hoarding disorder manifests as difficulty in discarding or letting go of items irrespective of their actual worth and persistent acquisition of items. Increasing numbers of possessions clutter active living spaces to the point where their intended use is no longer possible, leading to significant functional impairment. In the Diagnostic and Statistical Manual of Mental Disorders (DSM-V), it is classified under the category obsessive-compulsive and related disorders. First considered to be a part of obsessive-compulsive disorder, compulsive hoarding was subsequently classified as an additional dimension of the obsessive-compulsive disorder spectrum. Hoarding disorder had been largely ignored clinically until recently, despite negative consequences on individuals, families, and communities. Comorbid conditions like anxiety, depression, obsessive-compulsive disorder, post-traumatic stress disorder, and panic disorder are well known to accompany hoarding disorder. This study illustrates the case of a 35-year-old married man who was referred to a psychiatrist by his primary care physician for collecting many different objects of little or no importance. These objects were lying unorganized throughout his house and cluttering most of his living space. Some of these things were discarded by his wife, which, according to him, contributed to his emotional distress. The pattern of behavior began about 10 years earlier, and it became increasingly problematic with time. Although hoarding disorder is often underreported, it is vital to diagnose this condition as it significantly affects the individual and their family and friends. Severe hoarding can pose a number of health and safety risks, including fire hazards, tripping hazards, and health code violations.