Department of Psychosis Studies, King's College London, Institute of Psychiatry, London, UK.
Clin Psychol Rev. 2012 Apr;32(3):165-76. doi: 10.1016/j.cpr.2011.12.003. Epub 2011 Dec 23.
A new diagnosis termed Hoarding Disorder has been proposed for inclusion in the upcoming DSM-5 to cover the majority of cases where severe hoarding occurs in the absence of, or independently from other mental disorders. Much effort has been directed to ensuring that the proposed criteria discriminate Hoarding Disorder from other mental disorders, particularly those historically associated with hoarding (e.g. OCD, OCPD). Considerably less attention, however, has been paid to addressing the suitability of the proposed criteria for effectively differentiating pathological hoarding from normative collecting behavior. This is crucial in order to avoid false positives or the overpathologization of this widespread human activity. Collecting behavior mirrors many of the core features of hoarding (e.g. the acquisition of and emotional attachment to a potentially large number of objects), is highly prevalent and is generally considered a normative form of object amassment; as such, it represents a valid population with which to explore the diagnostic boundaries of Hoarding Disorder. Examination of the collecting literature, within the context of the hoarding diagnostic criteria, indicates that, for the majority of collectors, a diagnosis of Hoarding Disorder is likely to be effectively ruled out. For a minority of 'extreme' collectors, a diagnosis may potentially be adequate. This review highlights the similarities and differences between hoarding and collecting and offers suggestions for further research in this group.
一种新的诊断术语“囤积障碍”已被提议纳入即将出版的 DSM-5 中，以涵盖在没有其他精神障碍或独立于其他精神障碍的情况下发生严重囤积的大多数情况。人们已经付出了很大的努力来确保所提议的标准将囤积障碍与其他精神障碍区分开来，特别是那些与囤积有历史关联的障碍（例如 OCD、OCPD）。然而，对于所提议的标准是否适合有效地将病理性囤积与正常的收藏行为区分开来，人们关注的要少得多。为了避免假阳性或对这种广泛的人类活动过度病理化，这一点至关重要。收藏行为反映了囤积的许多核心特征（例如对大量物品的获取和情感依恋），它非常普遍，通常被认为是一种正常的物品积累形式；因此，它代表了一个有效的人群，可以用来探索囤积障碍的诊断界限。在囤积诊断标准的背景下，对收藏文献的研究表明，对于大多数收藏家来说，不太可能被诊断为囤积障碍。对于少数“极端”收藏家来说，可能需要进行诊断。本综述强调了囤积和收藏之间的异同，并为该群体的进一步研究提供了建议。
