THE DEVELOPMENT OF THE HOARD QUESTIONNAIRE: A SCREENING INSTRUMENT FOR HOARDING DISORDER.

Abstract

abstract Aims and hypothesis The aim of this study was to conduct preliminary validation of a self-administered five item screening questionnaire for Hoarding Disorder. Background Hoarding disorder has been estimated to affect 2-5% of adults during their lifetime. It is a chronic condition which tends to manifest as a clinical problem later in life, yet it has been established that certain characteristics could begin in early adulthood. It is defined as acquisition and failure to discard objects of little value or use. This results in heavily cluttered living spaces, making them unusable. This condition is very disabling and accidental fatalities have occurred due to unsafe accumulations of objects. Although there are instruments which measure the severity of Hoarding Disorder, there is a lack of a simple- self-administered screening questionnaire for the condition. This study therefore chose to conduct preliminary validation on the HOARD Questionnaire, which is a five-item, binary response, screening questionnaire for Hoarding Disorder. It has been developed at the National and Trustwide OCD/BDD Service, South West London and St George's Mental Health NHS Trust. Methods Patients treated by the National and Trustwide Service for OCD/BDD, were asked to complete the HOARD questionnaire. All patients’ responses were compared with their diagnosis of Hoarding Disorder which was made following observation and interviews in their home by specialist mental health workers. Results Fifty-two patients completed the questionnaire, five of whom, had significant Hoarding Disorder on clinical assessment. Using a score of 3/5, the HOARD identified three of these five patients (false positive result in 13/52) (sensitivity 60.0% and specificity 72.3%). Conclusions Further investigation with a larger number of subjects is necessary before the use of the HOARD can be advocated widely. This preliminary investigation suggests it is an easy to use, sensitive and specific tool, which may have a future role in early identification of individuals at a risk of developing Hoarding Disorder.