Nonetheless, accumulating evidence suggests that prevalence rates in children and adolescents are similar to those seen in adults. It appears that hoarding can exist separately from other aspects of pediatric obsessive-compulsive disorder (OCD).
Hoarding disorder is characterized by three main symptoms:
- Persistent difficulty discarding (throwing away) or parting with possessions
- The person has trouble parting with possessions due to a perceived need to save the items and distress associated with discarding them
- The difficulty discarding leads to significant clutter in active living areas that interferes with their intended use. For example, a person may be unable to use his or her dining room table, couch, and/or bed because of clutter.
Sometimes individuals with hoarding disorder also excessively acquire items that are not needed or for which there is no available space. The person may purchase the items (for example from stores or yard sales) or excessively acquire free items (for example, items that have been discarded).
People with hoarding disorder may hoard one type of item (for example, collectible figurines), several types of items, or a wide range of items (including garbage or other items that most people would consider worthless). Some individuals hoard animals with the goal of “saving” or caring for stray or impounded animals. Hoarding behaviors become a clinical problem when they cause distress or when they impair the person’s life (for example, by preventing the individual from inviting others to visit, or by causing health and safety problems).
Given that children and adolescents have limited control over their entire home due to parental influences, clutter may be primarily limited to their own bedroom. There is evidence suggesting that excessive clutter and acquisition may occur less frequently in youth, likely due to adults’ greater control over their environment and financial resources.
People with hoarding disorder can have varying levels of insight about their symptoms. Some individuals with good insight recognize that their behaviors are problematic. However, other individuals believe that their difficulty discarding and clutter are not problematic at all. These individuals may be less likely to pursue or respond to treatment.