Hoarding disorder studies are primarily based on persons who seek treatment and demonstrate good insight. The aim of the present study is to evaluate whether there are differences between community and treatment-seeking samples of individuals with hoarding disorder (HD).

Fourteen people with HD from the community and twenty treatment-seeking people with HD were assessed by a battery of instruments to evaluate HD features and other associated characteristics.

Compared to the treatment-seeking sample, the HD community sample was older, had poorer insight, and had a lower prevalence of comorbid obsessive-compulsive disorder (OCD). There were no differences in gender, education, presence of psychiatric comorbidities, quality of life, and hoarding behavior characteristics between the samples. The final logistic regression model with the Dimensional Obsessive-Compulsive Scale (DOCS) as the single predictor of treatment-seeking status was statistically significant, indicating that it was able to distinguish between the two samples. The model explained between 20.7% and 27.9% of the variance of subjects, and correctly classified 67.6% of cases.

Our results indicate that there appear to be few differences between the treatment-seeking and community samples of individuals with HD. The presence of comorbid OCD in treatment-seeking groups seems to be more frequent than in HD community samples.

People with hoarding behaviours often struggle to engage in treatment. This study aimed to explore the experiences of a sample of people who identify as engaging in hoarding behaviours and who are seeking support. Exploring motivation to seek help, the barriers those who hoard face in accessing support and what facilitates accepting help, can aid understanding of how best to intervene.

Eight individuals who self-identified as seeking help in relation to hoarding behaviours were recruited via social media and support groups. Interviews were conducted by telephone or video call, before being transcribed and analysed using interpretative phenomenological analysis.

Participants described complex help-seeking narratives and reported continued ambivalence about addressing their hoarding behaviours. The four group experiential themes identified were Wrestling with identity; Who can I trust?; Services don’t fit; and Being overlooked: ‘they’re too busy looking at the thing, not the person’. Difficulties trusting others and services were identified; services were experienced as rejecting and many participants sought help for problems other than their hoarding. Problems accessing appropriate help for hoarding were predominant in the narratives, although participants who had accessed peer support described this as valuable.

There are both internal (e.g. fear of judgement; feeling overwhelmed) and external (e.g. service gaps) barriers that make finding useful help for hoarding behaviours very difficult. Services may facilitate those seeking help by taking a compassionate and person-centred approach to hoarding problems.

1. (1) To assess the effectiveness of a multi-agency hoarding conference at improving understanding and confidence in working with hoarding problems.

2. (2) To explore professionals’ perceptions of improvements to multi-agency service provision.

3. (3) To explore perceptions of improvements that could be made to multi-agency service provision from people with personal experience of hoarding problems.

Hoarding disorder (HD) can be understood through the cognitive behavioural model in the context of vulnerability factors (for example, personality traits, co-morbidities, traumatic life events) and beliefs about possessions (for example, identity, emotional attachment, memory, utility). Less is known about the strength of these hypothesised beliefs, or how they interact within the hoarding population, with researchers suggesting that specifying beliefs would improve treatment outcomes.

The current study explored beliefs in HD, utilising Q-methodology to explore both categories of beliefs and the interactions between these. Moreover, Q-methodology allowed for comparison of the individuals endorsing specific categories of beliefs.

A comprehensive list of beliefs about possessions was developed. Thirty-two adults with clinically significant levels of HD completed a Q-sort task, alongside measures of proposed vulnerabilities, including co-morbidity, trauma and attachment style.

Q-factor analysis produced four profiles consisting of groups of participants who endorsed the same beliefs and had shared characteristics: (1) ‘Expression of identity’, (2) ‘Responsibility and morality’, (3) ‘Stability and predictability’, and (4) ‘Objects as emotional and meaningful beings’.

The profiles were distinguished by different categories of beliefs and co-morbid symptoms, suggesting that more targeted assessment tools and interventions would be beneficial to account for this heterogeneity within the clinical population. In particular, beliefs about identity and self-concept formed the largest profile, and beliefs about stability and predictability introduce a novel category of beliefs.

1. (1) Hoarding disorder (HD) is a poorly understood disorder that can significantly impact an individual’s personal, social and occupational functioning.

2. (2) According to a cognitive behavioural model, HD emanates from information-processing deficits, emotional attachment difficulties, behavioural avoidance and maladaptive beliefs about objects and the self (Frost and Hartl, 1996).

3. (3) Observations from this case study suggest the acceptability and effectiveness of a remote cognitive behavioural therapy (CBT) intervention for HD, with outcomes appearing congruous with those produced by face-to-face intervention.

4. (4) While research attests to the effectiveness of a CBT intervention for HD, an augmented account of the mechanisms through which these outcomes are achieved is required.

It has long been theorized that Obsessive-Compulsive Disorder (OCD) and Compulsive Buying Disorder (CBD) may share important characteristics, increasing the likelihood of the cooccurrence of these two psychiatric disorders. On the other hand, Hoarding Disorder (HD) were originally conceptualized to exist only within the context of OCD, despite hoarding symptoms presenting in less than 5% of OCD cases.

This study aims to provide an overview of impulsive-compulsive spectrum, regarding the similarities and differential diagnosis between compulsive buying and hoarding.

The authors performed a non-systematic literature review, using PubMed search terms “compulsive buying”, “hoarding” and “obsessive-compulsive spectrum”.

Obsessive-compulsive spectrum disorders are a group of similar psychiatric disorders characterized by repetitive thoughts, distressing emotions and compulsive behaviors. Compulsive buying is defined by a preoccupation with buying and shopping, by frequent buying episodes or overpowering urges to buy that are experienced as irresistible and senseless. These episodes are accompanied by relief and pleasure, but followed by remorse and guilt. A sub‐group compulsively hoard the items they have bought. Hoarding disorder is characterized by persistent difficulty discarding items regardless of value, urges to save items and distress associated with discarding, and the accumulation of possessions which compromise use of the home.

Empirical evidence suggests that both OCD and CBD display high levels of impulsivity and compulsivity. However, given the phenomenology, CB may not fit well in OCD related disorders. It may be also misleading to classify HD as part of OCD, since hoarding has the lowest specificity and predictive criteria for OCD.

No significant relationships.

Diogenes syndrome is a neurobehavioural syndrome characterised by domestic squalor, hoarding and lack of insight. It is an uncommon but high-mortality condition, often associated with dementia.

To describe the clinical features and treatment of Diogenes syndrome secondary to behavioural variant frontotemporal dementia (bvFTD).

We describe a case of bvFTD in a 77-year-old man presenting with Diogenes syndrome.

The patient's medical and psychiatric histories were unremarkable, but in recent years he had begun packing his flat with ‘art pieces’. Mental state examination revealed confabulation and more structured delusions. Neuropsychological evaluation outlined an impairment in selective attention and letter verbal fluency, but no semantic impairment, in the context of an overall preserved mental functioning. Brain magnetic resonance imaging and positron emission tomography (PET) with fluorodeoxyglucose showed mild bilateral temporo-insular atrophy and hypometabolism in the left-superior temporal gyrus respectively. An amyloid PET scan and genetic analysis covering the dementia spectrum were normal. A diagnosis of bvFTD was made.

The clinical framing of behavioural symptoms of dementia such as hoarding poses a diagnostic challenge. This case illustrates the importance of a deeper understanding of Diogenes syndrome, leading to timelier diagnosis and effective therapeutic strategies.