The Bowerbird Symptom': A Case of Severe Hoarding of Possessions

Abstract

Objective: To describe a severe case of hoarding of possessions in a patient with obsessive-compulsive disorder. Clinical picture: A 22-year-old male presented with a history from early childhood of persistent collecting of valueless objects and the inability to give up possessions. He had significant insight but ambivalent feelings about changing his behaviour, despite the degree of disruption it produced in his environment. Treatment and outcome: Attempts to engage the patient in treatment were unsuccessful because of the patient's ambivalence towards change. Conclusions: The symptom of hoarding behaviour may be a severe and disruptive expression of psychiatric distress, and in obsessive-compulsive disorder it is likely to indicate a poor prognosis due to the difficulties of engaging the patient in treatment.