PHOTOGRAPH-AIDED ASSESSMENT OF CLUTTER IN HOARDING DISORDER: IS A PICTURE WORTH A THOUSAND WORDS?
Article first published online: 28 AUG 2012
© 2012 Wiley Periodicals, Inc.
Depression and Anxiety
Volume 30, Issue 1, pages 61–66, January 2013
How to Cite
de la Cruz, L. F., Nordsletten, A. E., Billotti, D. and Mataix-Cols, D. (2013), PHOTOGRAPH-AIDED ASSESSMENT OF CLUTTER IN HOARDING DISORDER: IS A PICTURE WORTH A THOUSAND WORDS?. Depress. Anxiety, 30: 61–66. doi: 10.1002/da.21989
- Issue published online: 8 JAN 2013
- Article first published online: 28 AUG 2012
- Manuscript Accepted: 21 JUL 2012
- Manuscript Revised: 18 JUN 2012
- Manuscript Received: 18 APR 2012
- hoarding disorder;
- obsessive compulsive disorder;
- diagnosis, assessment
Clutter impeding the normal use of living spaces is a landmark feature of hoarding disorder (HD) but can also be present in other conditions. The assessment of clutter ideally requires home visits, although such assessments are sometimes not feasible. This study examined whether photographs from patients’ homes can assist in the diagnostic process.
Thirty-two professionals with experience with hoarding cases were shown pictures from the inside of 10 houses and asked to decide whether the house belonged to a person with HD, a person with obsessive compulsive disorder (OCD), or a healthy collector. Participants also rated different features of the room appearing in each picture (overall amount of possessions, tidiness, functionality, number of different classes of items, and cleanliness).
Sensitivity for the HD and collectors’ pictures was high, whereas sensitivity for the OCD pictures was substantially lower. Specificity was high for all groups. Rooms belonging to HD individuals were rated as significantly more cluttered, more untidy, less functional, containing a higher number of different classes of items, and being less clean than the rooms from the remaining groups.
Photographs may be used to assist clinicians in determining the presence of clinically significant levels of clutter in the event a home visit is not feasible. Although differential diagnosis will usually not be possible from photographs alone, examination of certain characteristics of the environment might provide useful diagnostic clues. Combined with a thorough psychopathological interview, the use of photographs may increase the clinician's confidence in the diagnosis of HD. Depression and Anxiety 00:1-6, 2012. © 2012 Wiley Periodicals, Inc.