Hoarding >> Facts About Hoarding

Hoarding is often a hidden issue in family medicine. Patients with hoarding problems often present with a sentinel event such as a fall or residential fire. Although hoarding is traditionally associated with obsessive-compulsive disorder, Facts About Hoarding patients more commonly have secondary organic disease associated with hoarding behaviour or have hoarding in absence of substantial compulsive traits. 

Hoarding disorder is expected to be included in the Diagnostic and Statistical Manual of Mental Disorders,5th edition. Management is best provided by a multidisciplinary approach when possible, Facts About Hoarding and an increasing number of centres provide programs to improve symptoms or to reduce harm. Pharmacologic management has been shown to be of some help for treating secondary causes. 

In the elderly, conditions such as dementia, depression, and substance abuse are commonly associated with hoarding behaviour. Attempts should be made to keep patients in their homes whenever possible, Facts About Hoarding but an assessment of capacity should guide the approach taken. Conclusion Hoarding is more common than family physicians realize. 

If hoarding is identified, local resources should be sought to assist in management. Assessment and Facts About Hoarding treatment of underlying causes should be initiated when secondary causes are found. It is expected that primary hoarding will be a new diagnosis in the Diagnostic and Statistical Manual of Mental Disorders, 5th edition.

Although hoarding has received a great degree of attention in the media, it remains a hidden problem in family medicine. Patients with pathologic hoarding behaviour, particularly elderly patients, Facts About Hoarding are often identified by a sentinel event such as a fall or residential fire when their home situation becomes a crisis. 

Treatment of hoarding is notoriously challenging and raises many ethical and legal issues related to safety and Facts About Hoarding capacity.This paper will review the presentation of hoarding and basic management approaches and resources for family physicians. Go to: Case Ms L., an 86-year-old woman, was admitted to hospital after her friend found her lying on the living room floor. 

The friend drove Ms L. to the grocery store each week, but she had not been in the home before, Facts About Hoarding as Ms L. had always met her at the end of the driveway. Ms L. was brought by emergency medical services staff to the emergency department, where she was admitted with a urinary tract infection and renal failure due to rhabdomyolysis. 

Her medical condition stabilized quickly, Facts About Hoarding and she was referred for geriatric rehabilitation to help her return home. The hospital chart documented that the ambulance staff reported that the house was in "poor shape," but not until the friend contacted a social worker with photos of the inside of Ms L.'s house was the extent of the problem clear.

Ms L. did very well during her rehabilitation stay and might have been physically able to return home, save for the deplorable conditions inside of her house that raised questions about her capacity. The Public Guardian and Facts About Hoarding Trustee became involved after a subsequent finding of financial incapacity; the patient's home was padlocked after a building inspector refused to enter the premises owing to safety concerns.

Go to:Sources of information Pub Med was searched from 2001 to May 2011. The MeSH term hoarding was used to identify research and review articles related to the neuropsychological aspects of hoarding and Facts About Hoarding its diagnosis and treatment. Most research was limited by small samples and by mixed populations of patients with hoarding and obsessive-compulsive disorder (OCD).

Go to: Main messages Epidemiology Hoarding behaviour is found in at least 2% to 5% of the population 1 and Facts About Hoarding it can have substantial individual and societal costs. The city of San Francisco, Calif, estimated the annual cost of dealing with hoarding to be $6.5 million, excluding the cost of health care workers involved in care.

2 Fire officials in Melbourne, Australia, found that hoarding was a factor in 25% of fires deemed to be preventable.Although the prevalence of hoarding is higher among older patients, Facts About Hoarding most people with hoarding behaviour not due to identifiable organic causes (ie, primary hoarding or hoarding disorder) start to show signs in adolescence or young adulthood. 

3 Falls are the most common event unmasking borderline living situations.Terminology and definitions Hoarding is a complex set of behaviour that exists on a continuum, Facts About Hoarding from being a messy and very disorganized collector at one end to living in abject filth and squalor at the other. The latter situation occurs as affected individuals' usually worthless material possessions invade their homes and essentially take over their lives, negatively affecting their quality of life.

The conceptualization and nomenclature of hoarding are currently undergoing revision. The Diagnostic and Facts About Hoarding Statistical Manual of Mental Disorders(DSM), 4th edition, includes hoarding behaviour as 1 of 8 criteria for OCD, and the traditional view has been of hoarding as a sub-type of OCD. 

There are DSM-V criteria for a newly proposed hoarding disorder in development, 5 but in practical terms, Facts About Hoarding hoarding can be defined as a behavioural disorder characterized by the following:the excessive accumulation of material possessions of dubious value and quality; the character and quantity of such possessions substantially interferes with an individual's normal social, functional, and vocational roles;

The individual cannot or will not willingly part with these possessions; and finally the individual often lacks insight into the safety risk their possessions can cause. Note that the safety risks can be direct (eg, spoiled food that is not discarded, Facts About Hoarding fire hazard from the accumulation of combustibles, piles toppling onto persons or pathways through home).

Or indirect (eg, possessions becoming home to pests and vermin, possessions interfering with the ability to prepare and eat meals, important items such as outstanding bills and medications lost in the clutter). Some authors suggest viewing hoarding as either being due to organic illness or as a primary condition, Facts About Hoarding sometimes termed hoarding disorder. 

Compulsive hoarding should be used only for describing the problem when it occurs in conjunction with OCD. Hoarding disorder is more likely to be seen in younger patients.1 Organic hoarding due to secondary conditions is more common in older patients, Facts About Hoarding owing to a higher likelihood of concurrent conditions. 

These include dementia, particularly frontotemporal lobar degeneration (FTLD), stroke, alcoholism, and severe depression. Brain injury patients might display hoarding behaviour, and Facts About Hoarding they provide a model for the biologic and anatomic basis of organic hoarding. Schizophrenia can present late in life and might also cause hoarding behaviour. 

A prospective study of referrals to geriatric psychiatry in Sydney, Australia, found that the causes of moderate to severe squalor were dementia (35%), substance abuse (24%), schizophrenia (15%), and Facts About Hoarding personality disorder (7%), with the remainder owing to physical illness, depression, or no definite diagnosis. 6 Box 1 describes features suggestive of the presence of organic causes.

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