Course of compulsive hoarding and its relationship to life events

Abstract

Compulsive hoarding is a common and debilitating, yet poorly understood, condition characterized by excessive acquisition of and failure to discard a large number of objects, resulting in cluttered and often hazardous living conditions. The aim of this study was to examine the onset and course of compulsive hoarding, and the relationships between stressful or traumatic life events and course of illness. Seven hundred fifty-one adults with self-reported hoarding symptoms completed an online survey regarding the severity of hoarding behavior over the lifespan and the incidence of stressful or traumatic life events. Median age of onset was between 11 and 15 years, with most respondents reporting symptom onset before age 20. Late-onset (e.g., after age 40) hoarding was rare. Most respondents described a chronic course of illness, with a significant minority describing an increasing or relapsing/remitting course. Stressful and traumatic events were common in this sample; changes in relationships and interpersonal violence were disproportionately associated temporally with periods of symptom onset or exacerbation. These results highlight the chronic nature of compulsive hoarding, its associated public health burden, and the potential impact of life stressors on symptom development. Directions for further research are discussed.