Study finds ADHD linked to ‘significantly higher’ risk of hoarding

(ORDO NEWS) — Many of us may find that we have acquired too many things that clutter up our living space, but refuse to part with things “in case we might need them.”

While having too many things is something many of us can compare to, for some people the constant difficulty of parting with possessions can become a problem – hoarding. When these tendencies significantly impair a person’s quality of life, it leads to a disease called hoarding disorder.

It is curious that understanding how hoarding manifests itself and how it relates to other difficulties in everyday life has not received much attention until recently.

It wasn’t until 2013 that hoarding disorder was formally recognized in the DSM-5 (the American Psychiatric Association’s guidelines for assessing and diagnosing mental illness) and its main characteristics were agreed upon.

In a recent study, we found that people with Attention Deficit/Hyperactivity Disorder (ADHD) had significantly more hoarding symptoms than the general population. This indicates that hoarding should be regularly assessed in people with ADHD.

Hoarding disorder is characterized by persistent difficulty throwing away items, regardless of their real value. This leads to an excessive accumulation of things that clutter up living spaces and interfere with their intended use. Hoarding disorder leads to severe distress and problems in communication, work, and other areas of daily functioning.

Anecdotally, we know that participants in clade studies often report attention problems, with many feeling they should be diagnosed with ADHD. Indeed, evidence suggests that people with hoarding disorder experience more attention problems than other people.

ADHD is a neurodevelopmental condition, one of the key characteristics of which is attention problems. “Inattention” includes trouble concentrating, as well as significant organizational difficulties, forgetfulness, procrastination, and being easily distracted to the point that it interferes with daily activities.

If there is a link between hoarding and inattention, what about people with ADHD? Do they have more hoarding problems than others?

Our research

We asked all patients at an adult ADHD clinic in the UK to complete a series of questionnaires about their personality traits and behaviors, including hoarding. The study involved 88 people – one third of the patients. A control group with similar characteristics of age, gender, and education who did not suffer from ADHD answered the same questions.

Using three different questionnaires, we applied thresholds previously set by researchers and clinicians for detecting treasure hunting. About 20 percent of participants with ADHD reported clinically significant symptoms of hoarding, compared to 2 percent in the comparison group (which is close to the 2.5 percent prevalence of hoarding in the population).

Hoarding was about equally common among both sexes, and patients with hoarding symptoms averaged 30 years of age. Clinically significant hoarding in patients with ADHD has been associated with lower quality of life and higher levels of depression and anxiety.

People with ADHD who did not meet the threshold for detecting hoarding still reported significantly more severe problems with hoarding compared to controls. In addition, people with more severe attention problems were more likely to report problems with hoarding.

Even if people do not suffer from ADHD or hoarding, many of them will experience the difficulties that are characteristic of these conditions, indicating that symptoms exist in different populations.

So we re-ran the online study with 220 UK participants and found that this time 3.6 percent scored above the threshold, and that again there was a strong link between inattention and hoarding.

The results of our study, which we understand to be the first to look at the presence of hoarding in adult patients with ADHD, suggest that people with ADHD should be regularly screened for symptoms of hoarding—especially given the limited awareness of any disorder associated with hoarding.

Although patients did not spontaneously raise issues related to hoarding in the clinic, they did approve of them when they were explicitly raised in our study.

Gaps in research

A limitation of our study is that hoarding symptoms were studied using self-reported questionnaires. Future studies should replicate these findings with trained clinical staff assessing the presence of hoarding through interviews. Future research should also explore why there is such an association between ADHD and hoarding.

In general, one of the problems that makes it difficult to understand the problem of hoarding and provide effective treatment is that many of those who suffer from hoarding have a limited outlook. This means that they do not always admit or accept that they are suffering from a mental disorder, or that they have a problem at all.

Research on hoarding disorders tends to focus on people who seek help or who are noticed by the health and welfare systems. Every now and then, studies describe samples of predominantly women around the age of 50.

But these participants report that serious hoarding began much earlier, often by the age of 20. In addition, indirect data from demographic studies indicate that hoarding is evenly distributed between the sexes.

Our study data indicate that our understanding of hoarding may be enriched if we turn to younger people with ADHD and hoarding to gain a better understanding of their symptoms. Ultimately, this may lead to better intervention and treatment for both ADHD and hoarding, and help clarify the link between the two disorders. The Conversation


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