囤積症又稱儲物症，其特徵為病人持續難以丟棄或分開物品，過度儲存，導致生活空間的雜亂，可嚴重影響其日常生活功能或人際關係。囤積症病人常收集他人認為無價值的物品，例如過期書報雜誌、用過的塑膠袋或紙箱、動物、過期食物或甚至是囤積電子檔案與郵件等。
囤積症的盛行率約為2%至6%，老年族群較年輕族群更常見。美國精神醫學學會自2013年起將囤積症定義為具有獨立診斷標準的精神疾病。囤積症病人常同時存在有憂鬱症、社交恐懼症、廣泛性焦慮症和注意力缺陷等精神病診斷。
囤積症的成因是多方面的，涉及認知因素（扭曲信念）、情緒因素（迴避負面情緒、罪惡感）、行為因素（逃避行為）、創傷壓力經歷、疏遠的人際關係等。病人常表現出對物品的強烈依附情感；孤獨感則可能導致或加劇囤積症狀。目前治療的主要方法是認知行為療法，其他治療方法包括慈悲焦點治療、完形治療、輔以藥物治療並存的焦慮與憂鬱等情緒。
囤積症病人親友應以同理心和耐心支持病人，避免批評，協助建立安全感，並鼓勵他們尋求專業協助。尊重病人意願和選擇，陪伴他們以舒適的步調逐漸改善囤積行為。基層醫師則應具備相關囤積症的識能，提升診療能力，以提供囤積症病人及其親友必要的支持。
(台灣家醫誌2025; 35: 67-75) DOI: 10.53106/168232812025063502001

關鍵詞： 囤積症、動物囤積症、認知行為療法、慈悲焦點治療、完形治療

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¹臺北榮民總醫院家庭醫學部
²國立陽明交通大學醫學院家庭醫學科
受理日期：114年1月6日 修改日期：114年2月6日 同意刊登：114年2月19日
^*通訊作者：林明慧 通訊地址：臺北市北投區石牌路二段201號 臺北榮民總醫院家庭醫學部
E-mail：mhlin@vghtpe.gov.tw
 

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Hoarding Disorder: Diagnosis and Recent Advances inTreatment
 
Ming-Hwai Lin^1,2*
 

Hoarding disorder is characterized by a persistent difficulty in discarding possessions andexcessive acquisition, resulting in a cluttered living environment that can seriously interfere withdaily functioning or interpersonal relationships. People with hoarding disorder often collect itemsthat others consider to be of little or no value, such as old books, newspapers and magazines, usedplastic bags or boxes, expired food, or even electronic files and emails.
The prevalence of hoarding disorder is about 2% to 6%, and it is more common in olderpeople than in younger people. Since 2013, the American Psychiatric Association has definedhoarding as a mental disorder with specific diagnostic criteria. People with hoarding disorder oftenhave co-existing psychiatric diagnoses such as depression, social phobia, generalised anxietydisorder and attention deficit disorder.
The causes of hoarding are multifaceted and may include cognitive factors (distorted beliefs),emotional factors (avoidance of negative emotions, guilt), behavioral factors (escape behavior),traumatic stress experiences, and impaired interpersonal relationships. Patients often show strongattachment to objects, and loneliness, in addition to being a cause, often exacerbates hoardingsymptoms. The main current treatment is cognitive behavioral therapy. Other treatments includecompassion-focused therapy, Gestalt therapy, and medication to treat co-existing anxiety anddepression.
Family members and friends of individuals with hoarding disorder should support them withempathy and patience, avoid criticism, help create a sense of security, and encourage them to seekprofessional help. Respecting their choices is essential while guiding them to improve their hoardingbehavior at their own pace. Primary care clinicians should be knowledgeable about hoardingdisorder and refine their diagnostic and treatment skills to provide the necessary support toindividuals with hoarding disorder and their family members.
(Taiwan J Fam Med 2025; 35: 67-75) DOI: 10.53106/168232812025063502001
 
Key words: animal hoarding disorder, cognitive behavioral therapy, compassion focused therapy,gestalt therapy, hoarding disorder

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¹Department of Family Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
²School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
Received: January 6, 2025; Revised: February 6, 2025; Accepted: February 19, 2025.
^*Corresponding author