Patient Perspectives on What Alleviates Hoarding Disorder Symptoms and Improves Wellbeing: A Systematic Review of Qualitative Data.

Hoarding disorder is a debilitating psychological disorder that is difficult to treat. Poor treatment response to current interventions indicates that new perspectives are needed. This systematic review examines qualitative and case study research on patient-centred strategies for reducing hoarding disorder symptoms and improving wellbeing. We conducted a comprehensive search of PsycInfo, Medline Complete, CINAHL, SocINDEX and Scopus in May 2025 to identify peer-reviewed qualitative research and case studies, published in English that examined hoarding disorder patients' first-hand experiences with strategies that improved their symptoms and wellbeing. We excluded papers that examined animal or digital hoarding, hoarding in the context of another disorder, hoarding in children or animals and papers with perspectives from only service providers or carers. The quality of studies was assessed using the Critical Appraisal Checklist for Qualitative Research Studies. Results were synthesized using thematic analysis. Twenty-one studies were included for review. Thematic analysis identified five key themes: interconnection, recognition of individuality and autonomy, self-care and acceptance, cognitive and behaviour change, and practical help. The papers included descriptions of therapeutic strategies (e.g., discarding tasks) and other factors identified as beneficial (e.g., meditation). Interconnection was the strongest theme, emphasizing the pivotal role trusted relationships play in helping individuals with hoarding disorder. The review indicates that individuals with HD may benefit from personalized care that focuses on interpersonal relationships, emotion regulation strategies, self-care, and in-home help for managing their symptoms and improving wellbeing.