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    Hoarding disorder

    囤积障碍

    Clinical diagnosis
    Also called
    HD, compulsive hoarding, hoarding

    What is hoarding disorder?

    Hoarding disorder is the build-up of possessions through repeated acquiring and difficulty discarding, driven by a felt need to save and distress at letting go, until the home cannot be used normally or safely, with marked distress or impairment.[1] DSM-5 first listed it as a separate diagnosis in 2013, and ICD-11 includes it too.[1][2][4]

    Diagnostic core (ICD-11)

    What it is not

    Schematic, not a self-test. The nine squares are our sketch, not the CIR’s photos.

    Select a box for details.
    Schematic. Top: the ICD-11 diagnostic core, repeated accumulation plus difficulty discarding that clutters the home until it cannot be used normally, with distress or impairment. Middle: insight, and how hoarding differs from collecting and from OCD. Bottom: nine squares sketch the idea behind the Clutter Image Rating, with the average scores of two groups in research. Select a part for details. Select a part for details
    Schematic. Top: the ICD-11 diagnostic core, repeated accumulation plus difficulty discarding that clutters the home until it cannot be used normally, with distress or impairment. Middle: insight, and how hoarding differs from collecting and from OCD. Bottom: nine squares sketch the idea behind the Clutter Image Rating, with the average scores of two groups in research. Select a part for details. Save as image (PNG)

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    Key points

    • Hoarding was long seen as a form of OCD. DSM-5 split it off because most cases cannot be attributed to OCD, the course differs, and OCD treatments work less well.[2]
    • Insight varies: some admit the items are useless or the home unsafe; others insist everything must stay. ICD-11 grades it in two levels. Poor insight and shame often deter help-seeking.[1][2]
    • A meta-analysis pooling 11 studies of about 53,000 adults put prevalence at about 2.5%, with no sex difference; most of the studies came from Europe and other developed countries.[3]
    • The best-supported treatment is multicomponent CBT for hoarding, including home practice in sorting, discarding and not acquiring. Trials are promising, but gains are modest and long-term effects unclear.[2]

    An example

    Lin collects stamps, buys only planned issues and files them in albums; the rooms stay usable. Ms. Wang’s living room is piled with old newspapers and boxes, and clutter covers the stove. When her daughter offers to help, she says everything will be useful and panics at discarding anything. The difference lies in selectivity, order and whether clutter disrupts life.[1]

    Misreadings and limits

    Collecting and thrift are not disorders in themselves: collectors are more selective and organized, and ICD-11 warns against mistaking cultural values of saving for disorder.[1] This page is not for self-diagnosis. If clutter gets in the way of cooking, sleeping or moving around, creates fire or other safety risks, or causes real distress, a doctor or mental health professional can help.[1][2]

    If you need help now

    If you’re struggling to cope or having thoughts of harming yourself:

    If you’re in immediate danger, call your local emergency number.

    Psyfield is not a crisis service. Numbers checked October 2026.

    Sources

    1. 1 World Health Organization (2025). 6B24 Hoarding disorder. ICD-11 for mortality and morbidity statistics (2025-01 release). View source
    2. 2 Mataix-Cols, D., & Fernández de la Cruz, L. (2018). Hoarding disorder has finally arrived, but many challenges lie ahead. World Psychiatry, 17(2), 224–225. doi:10.1002/wps.20531
    3. 3 Postlethwaite, A., Kellett, S., & Mataix-Cols, D. (2019). Prevalence of hoarding disorder: A systematic review and meta-analysis. Journal of Affective Disorders, 256, 309–316. doi:10.1016/j.jad.2019.06.004
    4. 4 Dozier, M. E., & Ayers, C. R. (2015). Validation of the Clutter Image Rating in older adults with hoarding disorder. International Psychogeriatrics, 27(5), 769–776. doi:10.1017/S1041610214002403

    Last checked against sources: October 28, 2026