Quiz: Hoarder or messy?

While compulsive hoarding can by a symptom of dementia, Alzheimer's disease, schizophrenia and some addiction disorders, it's most often seen in patients with obsessive-compulsive disorder (OCD). Research being conducted by the Department of Psychiatry and Behavioral Sciences at The John Hopkins University School of Medicine has found that hoarding symptoms occur in about 30 percent of people with OCD and in twice as many males than females. In a small number of cases, hoarding behavior can result from a neurological problem, such as a stroke, that affects the part of the brain that handles decision-making.

Dr. David Tolin, founder and director of the Anxiety Disorders Center at The Institute of Living at Hartford Hospital, estimates that about 3 to 6 million Americans may experience severe compulsive hoarding symptoms -- severe enough to impact their daily lives.

People with compulsive hoarding issues frequently have problems with information processing, certain beliefs about their possessions and have distress and anxiety about their possessions and objects they wish to acquire, but generally do not hoard because of aggression or anger issues.

The Clutter-Hoarding Scale was developed by the NSGCD as a tool for professional organizers to evaluate the levels of health and safety in a home. It measures household clutter and hoarding tendencies on a scale of 1 to 5 (Level I is low while Level IV is high) in four categories: 1) structure and zoning issues 2) pets and rodents 3) household functions 4) sanitation and cleanliness.

According to The Humane Society of the United States, an estimated 250,000 animals suffer from animal hoarding every year. Animal health professionals at the Cummings School of Veterinary Medicine at Tufts University have reported incidences with as many as 1,000 animals living in a single-family home.

Compulsive hoarding affects a person's thoughts, emotions and behaviors, but not necessarily sleep. In fact, the things hoarders collect may hold emotional significance, and hoarders generally report feeling safer when surrounded by their possessions. According to Clairmarie Szopa, MS, LCPC, NCC, adjunct faculty at National-Louis University and counselor at Choices Counseling & Coaching, "a hoarder's anxiety mounts until it becomes unbearable and is momentarily soothed by acquiring an item, even it that item is a duplicate of something already owned. In a compulsive situation the desire feels like a genuine need and is nearly constant and unrelenting."

Studies indicate that the tendency is greater in those who have family members who hoard. Researchers at the Department of Psychiatry and Behavioral Sciences at The John Hopkins University School of Medicine found that 84 percent of compulsive hoarders report hoarding behaviors in at least one first-degree relative.

Medications usually used to treat OCD are frequently used in treating people who hoard, including cognitive-behavioral therapy (CBT), pharmacotherapy and intensive multimodal treatment. A small number of hoarders have found that antidepressants (specifically, selective serotonin reuptake inhibitors) help manage emotions. Cognitive-behavioral, psychodynamic and multimodal therapies can also help change hoarders' thinking about their possessions and identify underlying issues.

The onset of hoarding symptoms is believed to start in adolescence (around age 12) or even as early as childhood, although the disorder can be insidious and symptoms aren't usually recognized until later in life, when the disorder may have reached epic proportions. According to the University of California at San Diego Obsessive-Compulsive Disorders Clinic, compulsive hoarders who participate in research studies are typically an average age of 50.

Clutter, trash, infestations and animal or human waste all pose health risks including respiratory and other illness. In addition, anxiety, depression and lack of mobility may result in increased cardiac and respiratory dysfunction as well as obesity. Clutter may block exits resulting in the inability to escape in an emergency, or even prepare food.