Psychiatry for Primary Care: An Update on Hoarding Disorder

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Note: This is the second part of a 2-part series covering the “Psychiatry for Non-Psychiatrists: The University of Arizona 2nd Annual Update in Behavioral Medicine for Primary Care” conference.—Ed.

The popularity of the A&E program Hoarders brought the psychiatric condition of hoarding into the public lexicon several decades ago. However, individuals tend to toss the terms “hoarder” and “hoarding” around without understanding the specificities of the disorder.

Because it is a common condition that impacts public health, we were absolutely thrilled to have Stanford Medicine’s Carolyn Rodriguez, MD, an expert in the field and author of Hoarding Disorder: A Comprehensive Clinical Guide, give a 30-minute presentation titled “Taming Clutter: Hoarding Disorder Research and Treatment Advances” for the 2nd Annual Psychiatry for Non-Psychiatrists conference on Saturday, March 11.

In 2013, the DSM-5 classified hoarding as a standalone condition with diagnostic criteria that include factors such as persistent difficulty discarding or parting with possessions, regardless of their actual value, due to a perceived need to save the items and the distress associated with discarding them. The criteria also include the accumulation of possessions that clutter active living areas and substantially compromise their intended use, and which cause a significant inability to maintain a safe environment.

The research and clinical understanding of excessive acquisition to the point of hoarding is still in its nascent stage, but we do understand some of the vulnerabilities and comorbidities that are at play.

Those prone to hoarding include individuals with a family history of hoarding, poor health or a disability, indecisiveness, perfectionism, procrastination, attention focus, and emotional regulation. Comorbidities include major depressive disorder, general anxiety disorder, seasonal affective disorder, and attention-deficit/hyperactivity disorder, among others.

There are several treatment interventions that show promise. Dr Rodriguez will include details on how to effectively identify hoarding disorder, the various treatment options—both medical and behavioral—and the research that informs these interventions.

We hope you join us and Dr Rodriguez on Saturday, March 11, to learn more about how to diagnose and treat your patients with hoarding disorder. Find conference details, including the schedule, description of presenters, and registration, at Psychiatry.arizona.edu/Psych4PCPs.

Dr Rodriguez is associate dean for academic affairs at Stanford University School of Medicine and a consultation-liaison psychiatrist at the Palo Alto Veterans Affairs.

Carolyn Rodriguez, MD

As the director of the Translational Therapeutics Lab and professor in the Department of Psychiatry and Behavioral Sciences, Rodriguez leads studies investigating the brain basis of severe mental disorders. Her landmark clinical trials pioneer rapid-acting treatments for illnesses including obsessive-compulsive disorder (OCD) and related disorders.

Her NIH-, foundation-, and donor-funded mechanistic and clinical efficacy studies span targeted glutamatergic and opioid pathway pharmacotherapy, noninvasive brain stimulation, psychotherapy, and suicide prevention. She is co-author of Hoarding Disorder: A Comprehensive Clinical Guide, published in 2022 by APA Publishing.

Dr Karp is professor and department chair of psychiatry at the University of Arizona College of Medicine—Tucson. He is an expert in the fields of geriatric psychiatry, depression treatment, and suicide prevention. He is committed to educating health care clinicians about the principles of psychiatry and behavioral medicine. 

Ms Manser is the communication and marketing specialist for the University of Arizona College of Medicine—Tucson Department of Psychiatry.