Question

Bill has expressed that he feels distressed that he fears throwing anything away, especially mail, papers, magazines, prescriptions, and prescription bottles that include his personal or financial information. He stressed that he has tried to shred the mail or papers, and even when shredded he can not throw the shredded information out for fear some will "put the pieces back together". He said that keeping everything has started to impact his socialization. He does not want friends, or anyone he is romantically interested in to see his home because he has stacks of paper and magazines, and pill bottles, and papers stacked all over his apartment. He also stated that he often is late to or misses work completely because he has to move and organize the papers and other kept items so that he can actually shower, make food, or sit comfortably on his couch.

1) Can Bill be diagnosed with a disorder? If yes, why?

2) What would be the disorder that Bill has the symptoms for? What are the symptoms of this disorder?

3) What treatment works well with this disorder? Please describe the treatment.

Answer 1

1. Bill can be diagnosed with a disorder. This is because his symptoms are impacting his ability to function adaptively in day-to-day life. It has impacted his social life, professional duties and the basic condition of his apartment.

2. It appears that Bill can be diagnosed with Hoarding Disorder. This disorder is characterised by the inability to throw away possessions, severe anxiety when attempting to discard items, difficulty organizing possessions, indecision about what to keep or where to put things and distress.

3. Cognitive behavioural therapy is the most common form of psychotherapy used to treat hoarding disorder. Techniques such as cognitive restructuring and exposure can be used to challenge beliefs around the extreme attachment to objects and explores the true consequences of discarding such objects.