- Persistent difficulty discarding or parting with possessions, regardless of their actual value.
- This difficulty is due to a perceived need to save the items and to distress associated with discarding them.
- The difficulty discarding possessions results in the accumulation of possessions that congest and clutter active living areas and substantially compromises their intended use. If living areas are uncluttered, it is only because of the interventions of third parties (e.g., family members, cleaners, authorities).
- The hoarding causes clinically significant distress or impairment in social, occupational, or other important areas of functioning (including maintaining a safe environment for self and others).
- The hoarding is not attributable to another medical condition (e.g., brain injury, cerebrovascular disease, Prader-Willi syndrome).
- The hoarding is not better explained by the symptoms of another mental disorder (e.g., obsessions in obsessive-compulsive disorder, decreased energy in major depressive disorder, delusions in schizophrenia or another psychotic disorder, cognitive deficits in major neurocognitive disorder, restricted interests in autism spectrum disorder).
With excessive acquisition: If difficulty discarding possessions is accompanied by excessive acquisition of items that are not needed or for which there is no available space.
With good or fair insight: the individual recognizes that the hoarding related beliefs and behaviours (pertaining to difficulty in discarding items, clutter or excessive acquisition) are problematic.
With poor insight: The individual is mostly convinced that hoarding related beliefs and behaviours
(Pertaining to difficulty in discarding items, clutter or excessive acquisition) are not problematic despite evidence to the contrary.
With absent insight or delusional beliefs: The individual is completely convinced that hoarding related beliefs and behaviours (pertaining to difficulty in discarding items, clutter or excessive acquisition) are not problematic despite evidence to the contrary.