The economic and social burden of compulsive hoarding

Psychiatry Res. 2008 Aug 15;160(2):200-11. doi: 10.1016/j.psychres.2007.08.008. Epub 2008 Jul 1.


The aim of the present study was to determine the economic and social burden of compulsive hoarding in a large sample of individuals with self-identified hoarding, as well as a separate sample of family members of individuals who hoard. Self-identified hoarding participants (N=864, 94% female, 65% met research criteria for clinically relevant compulsive hoarding) and family informants (N=655, 58% described a relative who appeared to meet research criteria for compulsive hoarding), completed an internet survey. Questions were derived in part from those used in the National Comorbidity Survey (NCS), and when possible, hoarding participants were compared to NCS participants. Compulsive hoarding was associated with an average 7.0 work impairment days in the past month, equivalent to that reported by individuals with psychotic disorders and significantly greater than that reported by female NCS participants with all other anxiety, mood, and substance use disorders. Severity of hoarding predicted the degree of work impairment after controlling for age, sex, and non-psychiatric medical conditions. Hoarding participants were nearly three times as likely to be overweight or obese as were family members. Compared to female NCS participants, hoarding participants were significantly more likely to report a broad range of chronic and severe medical concerns and had a five-fold higher rate of mental health service utilization. Eight to 12% had been evicted or threatened with eviction due to hoarding, and 0.1-3.0% had a child or elder removed from the home. These results suggest that compulsive hoarding represents a profound public health burden in terms of occupational impairment, poor physical health, and social service involvement.

Publication types

  • Comparative Study
  • Research Support, N.I.H., Extramural

MeSH terms

  • Absenteeism
  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Comorbidity
  • Compulsive Behavior / diagnosis
  • Compulsive Behavior / economics
  • Compulsive Behavior / epidemiology
  • Cost of Illness*
  • Diagnostic and Statistical Manual of Mental Disorders
  • Family / psychology
  • Female
  • Health Expenditures / statistics & numerical data*
  • Health Surveys
  • Humans
  • Male
  • Mental Disorders / economics
  • Mental Disorders / epidemiology
  • Mental Disorders / psychology
  • Mental Health Services / statistics & numerical data
  • Middle Aged
  • Morbidity
  • Obsessive-Compulsive Disorder / economics*
  • Obsessive-Compulsive Disorder / epidemiology*
  • Obsessive-Compulsive Disorder / psychology
  • Psychiatric Status Rating Scales
  • Severity of Illness Index
  • Social Work, Psychiatric / methods
  • Social Work, Psychiatric / statistics & numerical data
  • Surveys and Questionnaires