Compulsive buildup syndrome, also called buildup disorder (in the Diagnostic Manual of Mental Disorders, DSM-5), is a new disorder in the latest edition of the manual, but not a new disorder in clinical practice.
It is related to the classically known “Diogenes Syndrome”, although it presents important differences. Throughout this article we will use the name of compulsive accumulation syndrome to refer to the accumulation disorder of DSM-5 (they will be interchangeable).
What is compulsive buildup syndrome?
Compulsive accumulation syndrome is a psychological disorder linked to the accumulation of objects and possessions of all kinds, from furniture, writings and instruments to plants and other living things. As a disorder, it generates a significant discomfort for the person who manifests it, or for the people around him/her.
Differences with Diogenes Syndrome
The syndrome of compulsive accumulation or accumulation disorder is classified within the Obsessive-Compulsive Disorders, and differs from the classic “Diogenes Syndrome” in that the Diogenes Syndrome typically appears in patients with some type of dementia or frontal injury, as well as in patients with schizophrenia and/or with other important brain impairments.
In contrast, in binge eating syndrome there is no other mental disorder that better explains the symptoms, nor is it attributable to another medical condition such as brain damage, cerebrovascular disease, or Prader-Willy syndrome.
Furthermore, Diogenes Syndrome does not exist as an official diagnosis in any reference manual (neither in the ICD-10 nor in the DSM); it is more of a “popular” or social nomenclature.
Symptoms of compulsive buildup syndrome
Symptoms of binge eating syndrome include the following.
1. Difficulty in disposing of possessions
The patient shows great difficulty in getting rid of the possessions , and does not notice the real value they have (whether they have it or not).
2. Discomfort from disposal
The difficulty in disposing of things or objects is due to a perceived need to put things away; that is, “you need to put them away”. This need entails a significant discomfort associated with the fact of getting rid of the objects .
3. Accumulation of possessions
The above symptoms cause a large accumulation of various objects and possessions , be it furniture, old newspapers, broken toys, books, boxes, magazines, bags, etc. This accumulation congests and disorders the areas of the house destined to be lived in (for example the bathroom, the kitchen, the living room…), and significantly compromises their use.
Moreover, if the areas are tidy, it is thanks to the intervention of third parties (family members, authorities, cleaning staff…), never thanks to the patient himself who suffers from the compulsive accumulation syndrome.
4. Significant discomfort
The accumulation of objects leads to a significant psychological discomfort for the patient, and / or a deterioration of their daily functioning in all (or almost all) areas of their lives (personal, social, work …).
In addition, the patient’s environment may be dangerous for him/her and/or for others, with areas of the home being accumulated with objects, susceptible to fire for example.
In compulsive accumulation syndrome, the diagnosis should specify whether excessive acquisition is also included. This means if the person also buys, acquires (or orders) objects that are not necessary or for which there is not enough space in the home.
Other specifications included in the DSM-5 for compulsive build-up syndrome are
- With good or adjusted disease awareness.
- With poor disease awareness.
- With no awareness of illness/delirium.
It is estimated that between 2-6% of the US population suffers from it. In terms of prevalence, in the general population (without mental disorder), it is more prevalent in men than in women. However, in the clinical population (with some other mental disorder), there are more women than men with the compulsive accumulation syndrome.
It occurs more frequently in older people (especially between 55 and 94 years), versus young people (between 34 and 44 years). In addition, the first symptoms usually appear at 11 and 15 years of age.
Comorbidity with other disorders
It is considered a chronic disorder, even though it can be treated or improved . As regards its co-morbidity with other disorders, major depressive disorders, social phobias, GAD (Generalised Anxiety Disorder) and OCD (Obsessive Compulsive Disorder) are usually associated.
Specifically, 75% of the patients with the compulsive accumulation syndrome also have a mood or anxiety pathology. On the other hand, 20% of cases with the syndrome also have symptoms that meet OCD criteria. However, we must remember that none of the associated disorders fully explains the symptoms of binge eating syndrome.
As for its etiology, although the causes are not entirely clear, there are some risk factors for developing a compulsive accumulation syndrome , related to the person’s temperament, environment (setting) and genetics.
An indecisive or perfectionist temperament is typical of these patients.
2. Family history
Having a relative with binge eating syndrome also increases the likelihood of suffering from it yourself.
3. Stressful events
Going through a particularly stressful period, as well as the occurrence of certain stressful life events, is related to the appearance of accumulation disorder. These events include the death of a loved one, loss of possessions in a fire, an eviction, or a divorce, for example.
The risk factors are also related to a specific age of onset, as we have already seen; 11 and 15 years old. Over time, the symptoms become more severe . Older people are also more likely to develop them.
Psychological treatment may include cognitive behavioural therapy, as well as exposure techniques with response prevention (for example, exposing the patient to disposing of objects without regaining them) and important emotional support, especially to alleviate symptoms that are often accompanied, such as anxiety or depression.
At a psychopharmacological level, antidepressants or anxiolytics can be administered to treat the symptoms of the Compulsive Accumulation Syndrome.
- American Psychiatric Association (APA) (2014). DSM-5. Diagnostic and statistical manual of mental disorders. Madrid: Panamericana.
- Belloch, A.; Sandín, B.and Ramos, F. (2010). Psychopathology Manual. Volume I and II. Madrid: McGraw-Hill.
- Becerra, J.A., Robles, M.J. (2010). Characteristics of Accumulation Disorder: A New Clinical Syndrome? Biological Psychiatry, 17(3): 111 – 113.