Hoarding

Question 1

• Which sex is more affected by hoarding?

Answer 1

Males

Question 2

What is a “prominent” feature of pt w/ hoarding disorder?

Answer 2

Indecisiveness

Question 3

What 2 things can “precede” the onset / lead to a hoarding disorder??

Answer 3

• Stressful life event
• Traumatic life event

(often reported)

Question 4

What % of people w/ hoarding disorders report having a relative that also hoards?

Answer 4

50%

Question 5

Hoarders have difficulty discarding possession which results in accumulation of possessions which congest certain areas of the house.

• Which areas are more likely to be cluttered?
• Which areas are more likely to be cleared?

Answer 5

• Active living areas are cluttered (compromise intended use) –> can’t sleep in bed or cook in kitchen
• If living areas are uncluttered/cleared it is bc/ of interventions of 3rd parties such as family, cleaners, or authorities

Question 6

• What do you need to specify w/ hoarders?
• What % have this specific thing?

Answer 6

• If they are “excessively acquiring” items that are not needed or for which there is no available space
• 80 - 90%

Question 7

• What are the common features of people w/ hoarding disorder?

Answer 7

• Indecisiveness
• Perfectionism
• Avoidance
• Procrastination
• Distractibility
• Difficulty planning/organizing tasks

(IPPADD)

Question 8

• 75% of people with Hoarding Disorder have what other 2 disorders?
• 50% have what other disorder?
• 20% meet dx criteria for what disorder?

(these comorbid conditions are often reason they present for tx)

Answer 8

75%

• Comorbid mood
• Anxiety disorder

50%

• MDD

20%

• OCD

Question 9

• 1st line tx for Hoarding Disorder?
• Result of this tx?
• What to do if they fail 1st line?

Answer 9

• CBT of 26 sessions spread out over 1 year
• Modest reduction in sxs
• Screen for comorbid conditions

Question 10

At what age ranges can hoarding first appear?

Answer 10

11 - 15 yrs old

Question 11

At what age does hoarding start interfering w/ everyday functioning?

Answer 11

Mid 20s

Question 12

At what age is there clinically significant impairment from hoarding?

Answer 12

Mid 30s

Question 13

• Is hoarding chronic or acute disorder?
• Is hoarding constant or wax/wane?
• How often does the severity increase throughout a lifetime?

Answer 13

• Chronic
• Wax/wane
• Increases w/ each decade of lfie

Question 14

Give an example of hoarding leading to living in unsanitary conditions

Answer 14

Animal hoarding

Question 15

• 2nd line tx for Hoarding Disorder if pt has poor response/resistance/lack of access to CBT

Answer 15

• SSRI
  
  • Sertraline
  • Fluoxetine

Question 16

• What are 2 risks of people w/ Hoarding Disorder that need to be addressed at initial treatment appointment?
• What do you need to ask about patient’s living situation?

Answer 16

• Fires & Tripping (falls)
• If they live w/ children or elderly (who should be removed from hazardous home)