Compulsive accumulation syndrome, also called accumulation disorder (In the Diagnostic Manual of Mental Disorders, DSM-5) this is a new disorder in the latest edition of the manual, although it is not a new disorder in clinical practice.
It is linked to “Diogenes syndrome”, known classically, although it has important differences. Throughout this article we will be using the name compulsive accumulation syndrome to refer to DSM-5 accumulation disorder (they will be used interchangeably).
What is compulsive accumulation syndrome?
Compulsive accumulation syndrome is a psychological disorder related to the accumulation of objects and possessions of all kinds, from furniture, writings and instruments to plants and other living things. Being a disorder, it generates significant discomfort for the person who manifests it, or for the people around it.
Differences with Diogenes syndrome
Compulsive accumulation syndrome or accumulation disorder is classified as obsessive-compulsive disorder and differs from classical “Diogenes syndrome” in that Diogenes syndrome usually occurs in patients with a certain type of dementia or frontal injury, as well as in patients with schizophrenia and / or with other significant brain damage.
In contrast, in compulsive accumulation syndrome, there is no other mental disorder that better explains the symptoms, nor is it attributable to another medical condition such as brain damage, cerebrovascular disease or Prader’s syndrome. Willy.
In addition, Diogenes syndrome does not exist as an official diagnosis in any reference manual (neither in ICD-10 nor in DSM); it is rather a “popular” or social nomenclature.
Symptoms of compulsive hoarding syndrome
Symptoms of compulsive hoarding syndrome include the following phenomena.
1. Difficulty rejecting goods
The patient shows great difficulty in disposing of his belongings, And don’t notice the real value they have (whether they have it or not).
2. Discomfort of rejecting
The difficulty in rejecting things or objects, is due to a need that the person perceives to keep the objects; that is, “you must save them”. this need this involves significant discomfort related to the disposal of objects.
3. Accumulation of assets
The above symptoms cause a large accumulation of various objects and possessionsWhether it’s furniture, old newspapers, broken toys, books, boxes, magazines, bags, etc. This accumulation clutters and clutters the spaces of the house intended for living (for example the toilets, the kitchen, the living room …), and considerably compromises its use.
In addition, if the spaces are tidy, it is thanks to the intervention of third parties (relatives, authorities, cleaning staff …), never thanks to the patient himself who suffers from the compulsive accumulation syndrome.
4. Significant discomfort
The accumulation of objects causes significant psychological distress for the patient, and / or a deterioration of his daily functioning in all (or almost all) areas of his life (personal, social, professional …).
Outraged, the patient’s environment can be dangerous and / or for the others, being the areas of the house accumulated with objects, susceptible to fire, for example.
In compulsive accumulation syndrome, it should be clarified in its diagnosis whether excessive acquisition is also included. This means, if the person also buys, acquires (or orders) unnecessary items or for which there is not enough space in the accommodation.
The other specifications included in the DSM-5 for compulsive hoarding syndrome are:
- With awareness of a good or severe illness.
- With a bad conscience of the disease.
- With absence of illness / delusional consciousness.
It is estimated that between 2 and 6% of the American population suffers from it. As for its prevalence, in the general population (without mental disorder), it is more frequent in men than in women. However, in the clinical population (with another mental disorder) there are more women than men with compulsive hoarding syndrome.
It occurs more frequently in older people (Especially between 55 and 94 years old), compared to young people (between 34 and 44 years old). In addition, at the age of 11 and 15, the first symptoms usually appear.
Comorbidity with other disorders
It is considered a chronic disorder, although it can be treated or improved. As for their comorbidity with other disorders, major depressive disorders, social phobias, TAG (Generalized Anxiety Disorder) and OCD (Obsessive Compulsive Disorder) are often associated.
Specifically, 75% of patients with compulsive accumulation syndrome also have a mental or anxiety disorder. On the other hand, 20% of cases with the syndrome also have symptoms that meet the criteria for OCD. However, we must remember that none of the associated disorders fully explain the symptoms of compulsive hoarding syndrome.
As for its etiology, although the causes are not entirely clear, there are certain risk factors for developing compulsive hoarding syndrome, Linked to the person’s temperament, his environment (environment) and his genetics.
An indecisive or perfectionist temperament is typical of these patients.
2. Family history
Have a parent with compulsive hoarding syndrome it also increases the likelihood of suffering yourself.
3. Stressful events
Going through a particularly stressful period, as well as the occurrence of certain stressful life events, is linked to the onset of accumulation disorder. These events include the death of a loved one, loss of property in a fire, eviction or divorce, for example.
The risk factors are also linked to a specific age of onset, as we have already seen; 11 and 15 years old. Over time, symptoms get worse. The elderly are also more likely to develop it.
Psychological treatment it may include cognitive behavioral therapy as well as exposure techniques with response prevention (For example, exposing the patient to disposing of objects without retrieving them) and strong emotional support, especially to relieve symptoms that are often accompanied, such as anxiety or depression.
At the psychopharmacological level, antidepressants or anxiolytics can be administered to treat the comorbid symptoms of compulsive accumulation syndrome.
- American Psychiatric Association -APA- (2014). DSM-5. Diagnostic and Statistical Manual of Mental Disorders. Madrid: Panamericana.
- Belloch, A .; Sandín, by Ramos, F. (2010). Manual of psychopathology. Volumes I and II. Madrid: McGraw-Hill.
- Becerra, JA, Robles, MJ (2010). Characteristics of accumulation disorder. A new clinical syndrome? Biological Psychiatry, 17 (3): 111-113.