Health-related quality of life in hoarding: A comparison to chronic conditions with high disease burden

Hoarding disorder often results in debilitating functional impairment and may also compromise health-related quality of life (QoL). This study investigated the association between hoarding behavior and QoL relative to six highly impairing medical and psychiatric disorders in a sample of 20,722 participants enrolled in the internetbased Brain Health Registry. Nearly 1 in 8 participants (12.2%) endorsed clinically relevant hoarding symptoms (CHS). In separate multivariable linear regression models, hoarding was more strongly associated with mental QoL than diabetes (Standardized beta =-0.21, 95% CI: [-0.22,-0.20] vs.-0.01 [-0.02, 0.0]), heart disease (-0.22 [-0.23,-0.20] vs. 0.00 [-0.02, 0.01]), chronic pain (-0.18 [-0.19,-0.16] vs.-0.12 [-0.13,-0.10]), post traumatic stress disorder (PTSD;-0.20 [-0.22,-0.19] vs.-0.07 [-0.09,-0.06]), and substance use disorder (SUD;-0.21 [-0.23,-0.20] vs.-0.04 [-0.05,-0.03]). Similarly, CHS was more strongly negatively associated with physical QoL than diabetes (-0.11 [-0.10,-0.12] vs.-0.08 [-0.06,-0.09]), major depressive disorder mental (Standardized beta =-0.28, Delta R2 = 0.08, p < 0.0001) and physical (beta =-0.12, Delta R2 = 0.02, p < 0.0001) QoL, though the strength of the relationship between hoarding symptoms and QoL varied with depression severity. Efforts to improve the overall QoL and well-being of those with CHS are needed.