Detection of Hoarding Disorder and Related Psychopathology

Hoarding disorder is characterized by excessive amassment of objects in the home and difficulty of getting rid of the objects. It is associated with a high level of somatic and psychiatric comorbidity, suicidality, social marginalization, damage to property and risk of eviction. Previous clinical studies have mainly been in help-seeking groups. However, social services engage severe cases with poor insight, whereas few as 10% have contact with mental health services. This study investigates: 1. The prevalence of severe mental illness and comorbidities among 60 individuals with hoarding disorder that have led to contact with social services at Copenhagen Municipality 2. the effect of a cross-sectoral intervention aiming to establish contact with regional mental health services for these individuals. The intervention consists of an outreach team of clinicians and municipal social workers who refer participants to clinical services based on a systematic clinical assessment. Primary outcomes are 1) primary and comorbid diagnoses assigned at the clinical assessment and 2) contact with mental health services after the intervention, at 3- and 6-months follow-up. Six to 12 months after the baseline assessment, a qualitative follow-up interview will be carried out, including approximately 14 participants. The aim is to explore the participants' experience of the intervention and subsequent clinical and social services to provide a more nuanced understanding of the quantitative outcomes of the study. The hypotheses of the study are 1. more than 75% of the participants will be identified to have comorbid diagnoses including more than 50% with associated severe mental illness (schizophrenia, other psychotic disorders, bipolar disorder and periodic depression). It is expected that 10% will suffer from underlying organic disorders of dementia or mental retardation. 2. Fifty percent of the sample will establish contact with mental health services within 3 months after attempt of referral, and 30% of the sample will remain in contact for more than 6 months