A Single-Item Screening Tool for the Assessment of Hoarding: Preliminary Observations

J Neuropsychiatry Clin Neurosci. 2026 Feb 6:appineuropsych20250152. doi: 10.1176/appi.neuropsych.20250152. Online ahead of print.

ABSTRACT

OBJECTIVE: Hoarding disorder is defined as persistent difficulty discarding or parting with possessions, regardless of their actual value. Hoarding is associated with biopsychosocial distress and reduced quality of life, and although it is often associated with obsessive-compulsive spectrum disorders, hoarding is also encountered in cases of neurodegeneration. Assessments of hoarding behavior traditionally involve a comprehensive evaluation that may be challenging in clinical settings. The authors developed a simplified hoarding screen for patients with neurobehavioral disorders.

METHODS: The Single-Item Hoarding Screen (SIHS) is a single-item questionnaire. In total, 135 patients from the University of Colorado Behavioral Neurology Clinic were surveyed; caregivers filled out the SIHS. Patients’ diagnoses included a range of neurobehavioral disorders, including Alzheimer’s disease, behavioral variant frontotemporal dementia, Lewy body dementia, primary progressive aphasia, major neurocognitive disorder not otherwise specified, and minor neurocognitive disorder not otherwise specified.

RESULTS: The mean age of the patients was 70.9 years, and 39% were female. Among the patients surveyed, 10% and 13% of caregivers (23% total) answered yes and maybe, respectively, to the question on the SIHS. Yes responses on this screen were significantly associated with higher scores on the established Hoarding Rating Scale, compared with maybe responses. Statistical analyses revealed significant correlations between hoarding behaviors and neuropsychiatric symptom severity as well as caregiver well-being.

CONCLUSIONS: These results suggest the potential benefits of a tool containing only a single item to screen for hoarding behavior in neurobehavioral disorders. Future research may focus on refining and validating the SIHS.

PMID:41649237 | DOI:10.1176/appi.neuropsych.20250152