Hoarding Disorder

Abstract

A physically healthy 53-year-old woman is referred to her local mental health team for the management of depression and anxiety. On questioning, she reports that she has been living in the basement of her apartment building, eating in restaurants, and using a local gym for showers; her own apartment is so full of clothes, magazines, books, suitcases, and boxes jam-packed with items that she is no longer able to get in the door. The mere thought of discarding anything makes her intolerably anxious and upset. She reports having had difficulties discarding possessions for as long as she can remember. How should she be evaluated and treated?