A drawer that won’t close, piles of newspapers on the kitchen table, bags piled up in the hallway. Accumulation often starts with trivial items kept “just in case.” Syllogomania precisely refers to this disorder: the persistent inability to part with objects, even when they are no longer useful. Far from a simple lack of organization, this behavior eventually invades the living space to the point of making it difficult to inhabit.
What the DSM-5 Changed for the Diagnosis of Syllogomania
For a long time, compulsive hoarding was linked to obsessive-compulsive disorder. Relatives, general practitioners, and sometimes even psychiatrists treated it as a secondary symptom. Since the DSM-5 published by the American Psychiatric Association in 2013, and then confirmed by the DSM-5-TR in 2022, compulsive hoarding disorder is recognized as a standalone diagnosis.
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This distinction has direct consequences. A patient identified under this diagnosis can access behavioral and cognitive therapy protocols designed for hoarding, not for classic OCD. The cognitive mechanisms are not the same: in OCD, the person acts to reduce anxiety related to intrusive thoughts. In syllogomania, the difficulty in throwing away is linked to an emotional attachment to objects or a fear of losing potentially useful information.
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Confusion persists among the general public between syllogomania and Diogenes syndrome. Diogenes syndrome associates hoarding with severe self-neglect and extreme social isolation. Not every person with syllogomania is in a Diogenes situation, and this nuance conditions the type of support offered.
Concrete Signs of Compulsive Hoarding in Housing
Have you ever noticed that certain rooms in a friend’s home are no longer accessible? That the bathtub is used for storage, or that the bed is covered with clothes never worn? These situations do not fall under ordinary disorder. They signal a problem when they meet three simultaneous conditions.
- The accumulated objects clutter living spaces to the point of preventing their normal use (cooking, sleeping, washing)
- The person feels real distress at the thought of parting with them, even for items with no market value like packaging or brochures
- The accumulation causes a disruption in daily functioning: difficulties in social relationships, health risks, conflicts with neighbors or landlords
The disorder often starts discreetly, usually in adolescence. The first signs go unnoticed for years. The worsening is gradual and accelerates after a destabilizing life event: bereavement, separation, job loss, moving.
Post-Covid Accumulation: A Documented Phenomenon
Research published in the Weekly Epidemiological Bulletin of Santé publique France in 2023 noted an increase in reports of degraded housing in Paris during and after the Covid-19 pandemic. Elderly people living alone were particularly affected. The successive lockdowns acted as a revealer, sometimes as an accelerator of already latent hoarding disorders.
Prolonged social isolation removes the external gaze that, in normal functioning, acts as a regulator. Without visits, without regular interactions, the living space transforms without anyone noticing.
Psychological Mechanisms Behind the Difficulty in Throwing Away
Why keep a receipt from 2014 or thirty empty shoeboxes? From the outside, the behavior seems irrational. For the person concerned, each object carries a weight: a memory, a future possibility, a feeling of security.
Research in cognitive psychology identifies several biases at play:
- The potential utility bias: “it might be useful one day” justifies keeping almost everything
- Disproportionate emotional attachment: a mundane object becomes a vessel for a memory or identity
- Decision overload: faced with hundreds of objects, sorting becomes paralyzing, and the person ends up throwing nothing away
- The fear of waste, sometimes linked to a family history of deprivation or precariousness
These mechanisms also explain why a simple forced clean-up solves nothing. Emptying a home without prior therapeutic work often leads to a rapid relapse, accompanied by increased distress.
Behavioral and Cognitive Therapy Adapted to Hoarding
The most documented treatment is based on specialized CBT. This protocol does not involve learning to organize. It targets automatic thoughts related to objects and trains the person to make gradual sorting decisions in a safe environment.
The therapist works at home with the patient, in the real environment. Office sessions alone are not sufficient: the transfer of skills must occur where the hoarding exists. Each session focuses on a limited space (a drawer, a bag, a shelf) to avoid overload.
What CBT Does Not Do
It does not replace social support when the housing is uninhabitable. In severe situations, coordination between social services, landlords, and specialized cleaning teams is necessary. Clearing out alone, without psychological follow-up, leads in the vast majority of cases to re-accumulation within a few months.
Some medications (selective serotonin reuptake inhibitors) are sometimes prescribed as a complement, especially when a depressive or anxious disorder coexists. They do not treat the hoarding itself but can reduce the associated distress enough to make therapy accessible.
Syllogomania remains underdiagnosed, partly because those affected rarely seek help on their own initiative. Detection often relies on relatives, social workers, or professionals intervening at home. Naming the disorder without judgment remains the first step toward appropriate support.