Hoarding disorder and the law

While hoarding has been chronicled graphically by authors such as Dante, de Balzac, Dickens and Gogol, and has been the subject of sensationalist treatment by the media in respect of persons who are well known or who have become notorious, it has remained a subject of disparate clinical analysis, often subsumed under diagnoses of obsessive-compulsive conditions and concerns about old age squalor. It has been confused by ascriptions such as "Diogenes Syndrome", "Miss Havisham Syndrome", "Plyushkin Syndrome", "Syllogomania" and "Senile Squalor Syndrome", each of which is problematic or has significant limitations. Most commonly it has been correlated with both Obsessive Compulsive Disorder and schizophrenia but until the 2012 draft of DSM-V it has not been accorded the status of a disorder in its own right. However, with the likely elevation of its status by its inclusion as a stand-alone disorder in the DSM will come closer critical scrutiny, better clinical awareness, a fillip for further research, impetus for more effective treatment, and further exposure in the courts and tribunals. This editorial scrutinises the attention that hoarding of both articles and animals has already received in judicial and quasi-judicial decisions and identifies the many difficulties that it can pose for legal decision-making that is compassionate, rigorous and clinically informed.