Testing the validity and acceptability of the diagnostic criteria for Hoarding Disorder: A DSM-5 survey

D. Mataix-Cols, L. Fernández De La Cruz, T. Nakao, A. Pertusa

Research output: Contribution to journalReview articlepeer-review

22 Citations (Scopus)


Background The DSM-5 Obsessive-Compulsive Spectrum Sub-Workgroup is recommending the creation of a new diagnostic category named Hoarding Disorder (HD). The validity and acceptability of the proposed diagnostic criteria have yet to be formally tested.Method Obsessive-compulsive disorder/hoarding experts and random members of the American Psychiatric Association (APA) were shown eight brief clinical vignettes (four cases meeting criteria for HD, three with hoarding behaviour secondary to other mental disorders, and one with subclinical hoarding behaviour) and asked to decide the most appropriate diagnosis in each case. Participants were also asked about the perceived acceptability of the criteria and whether they supported the inclusion of HD in the main manual.Results Altogether, 211 experts and 48 APA members completed the survey (30% and 10% response rates, respectively). The sensitivity and specificity of the HD diagnosis and the individual criteria were high (80-90%) across various types of professionals, irrespective of their experience with hoarding cases. About 90% of participants in both samples thought the criteria would be very/somewhat acceptable for professionals and sufferers. Most experts (70%) supported the inclusion of HD in the main manual, whereas only 50% of the APA members did.Conclusions The proposed criteria for HD have high sensitivity and specificity. The criteria are also deemed acceptable for professionals and sufferers alike. Training of professionals and the development and validation of semi-structured diagnostic instruments should improve diagnostic accuracy even further. A field trial is now needed to confirm these encouraging findings with real patients in real clinical settings.

Original languageEnglish
Pages (from-to)2475-2484
Number of pages10
JournalPsychological Medicine
Issue number12
Publication statusPublished - Dec 2011
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • Applied Psychology
  • Psychiatry and Mental health


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