a1 Institute of Psychiatry, London
a2 Charter Nightingale Hospital, London
Obsessive-compulsive hoarding can be viewed within personality, neuroethological and cognitive-behavioural frameworks. Three cases of obsessive-compulsive hoarding are described in detail. All cases had some insight (albeit fluctuating) into their problem and were seeking treatment. There was evidence of abnormal risk assessment, fear of criticism, excessive guilt, overconscientiousness and inflated responsibility. Depression, emotional or material deprivation and significant loss during childhood and adolescence were experienced by all cases. The cases are considered to be consistent with a cognitive-behavioural model of obsessive-compulsive disorder emphasizing the importance of learning and cognition. Implications for treatment are discussed.