Assessing and addressing hoarding in ADHD: A call to action

People with attention-deficit hyperactivity disorder (ADHD) are more likely to experience co-occurring hoarding problems than the general population, yet current clinical practice guidelines for ADHD do not explicitly reference hoarding. Hoarding is characterised by difficulties with excessive acquisition of objects, difficulties discarding , and clutter. Excessive hoarding, when associated with significant impairment, may meet criteria for hoarding disorder. Hoarding disorder results in significant mental, physical, social and economic costs to individuals, families and the community. We briefly summarise the relationship between ADHD and hoarding problems and suggest possible reasons for the research-practice gap in identifying hoarding difficulties in ADHD patients. We then seek to present practical recommendations for clinicians working with people with ADHD to assist in identifying and managing hoarding concerns. We contend that though ADHD is complex and that hoarding difficulties can have a decades-long, incremental development, clinicians already have existing skills to improve quality of life among those with co-occurring ADHD and hoarding concerns. • Hoarding difficulties are more common in people with ADHD, but they may not be identified in routine clinical practice. • Clinicians assessing or managing adult ADHD are well placed to identify and manage hoarding problems.