TY - JOUR T1 - Hoarding disorder: evidence and best practice in primary care JF - British Journal of General Practice JO - Br J Gen Pract SP - 182 LP - 183 DO - 10.3399/bjgp23X732513 VL - 73 IS - 729 AU - Sharon Morein-Zamir AU - Sanjiv Ahluwalia Y1 - 2023/04/01 UR - http://bjgp.org/content/73/729/182.abstract N2 - With clinical, social, environmental, and legislative considerations, hoarding disorder (HD) poses unique challenges in relation to its diagnosis and treatment. Hoarding is characterised by excessive clutter and difficulty discarding. While many individuals may report dissatisfaction and difficulties with such symptoms alongside excessive acquisition, only when these lead to clinically significant distress and/or impairment in social, occupational, or other important areas of functioning is the diagnosis of HD considered.1 Hoarding is associated with significant physical, psychological, and social morbidity leading to reduced quality of life. Even safety can be affected by possessions that congest and clutter active living areas and substantially compromise their intended use. Relationships within the household, with extended family and friends, and even with neighbours may come under stain. HD is found across the world, with a prevalence of approximately 2% and with similar rates for males and females.2 Despite the prevalence and considerable personal costs, recognising and providing appropriate care can prove challenging. Only in 2013 was HD listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5)1 and in 2019 was it formally listed in the International Classification of Diseases (ICD-11, code F42.6B24).3 Beforehand, HD was classified under obsessive compulsive disorders (OCD). However, most patients with HD notably do not display the cardinal OCD symptoms of obsessions and compulsions, with further evidence of differing onset, course, pathophysiology, and treatment responses.1 This classification history has hindered research, clinical understanding, and treatment development.In clinical settings, recognising hoarding symptoms can prove challenging for several reasons. Hoarding behaviours often manifest by early adulthood, but patients and their families typically do not disclose difficulties to health professionals or seek help until decades later, if at all. This is due in part to the condition’s insidious nature together with management of symptom severity by family … ER -