Hoarding Disorder and Diogenes Syndrome: Two Case Reports and a Narrative Review

Hoarding disorder (HD) and Diogenes syndrome (DS) are challenging and multifaceted conditions that significantly impact patients and society. These disorders are characterized by excessive hoarding behaviors, often accompanied by multiple physical and mental comorbidities, diminished quality of life, and substantial public health challenges. Through the presentation of two case reports and a narrative review, this article revisits HD and DS, highlighting the need for clinical awareness, targeted management strategies, and further research in this field. The first case report describes a 35-year-old woman with early-onset HD and comorbid obsessive-compulsive disorder, while the second details a 78-year-old woman with DS related to vascular dementia. These cases underscore the necessity of timely diagnosis, multidisciplinary interventions, and comprehensive management to prevent deterioration, address physical health issues, improve hygiene and home safety, and mitigate harm to both patients and the community. Advanced treatments such as transcranial magnetic stimulation and electroconvulsive therapy may also play a role in managing these complex conditions. The development of practical guidelines is essential for the effective assessment and care of patients with such multidimensional needs. Moreover, there is a critical need for well-designed randomized controlled trials to evaluate and compare pharmacological and non-pharmacological treatment approaches.