Compulsive Hoarding

TREATMENT

Systematic treatment studies of compulsive hoarding have not been undertaken. Studies investigating pharmacological interventions are equivocal. The most common drug assisted treatments involve the use of the tricyclic antidepressant clomipramine (Anafranil) and the selective serotonin reuptake inhibitors SSRIs (see Table 3). Evidence using behavioural therapy with emphasis on response prevention, the gold standard treatment of OCD, is also equivocal. The therapy that is showing the most promise is derived from the cognitive behavioural model of compulsive hoarding. Fundamental to this approach is identification of the faulty thoughts and beliefs that drive the hoarding behaviour, challenging these faulty cognitions and replacing these cognitions with statements that are more rational. Following cognitive restructuring, a behavioural programme of gradual disposal is initiated, the sufferer always deciding what is to be discarded first. At times, treatment goes beyond the clinician to the public health official, sanitary and fire risk factors often the motivating factors behind such intervention. Regardless who intervenes, a gold standard rule is that touching or disposing of a hoarder’s items occurs only following the sufferer’s permission.

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