You raise some interesting points. A few thoughts. Generally, psychological conditions can be considered on a spectrum, an analogue scale (i.e. from you have

You raise some interesting points. A few thoughts. Generally, psychological conditions can be considered on a spectrum, an analogue scale (i.e. from you have none of this trait or condition, to you display huge amounts). You're absolutely right that the point at which Hoarding Disorder becomes diagnosable (currently, per DSM-5) is determined by the real-world effects on someone's life becoming severe and displaying a number of features. [0] However, I'd argue that for this subject, considering only the DSM-5 diagnostic criteria is too simplistic: a) There are plenty of people whose hoarding behaviour falls short of the formal diagnostic criteria, but which do still cause some level of problem for them in their life, or for other people who are in their life. (For example, you could have someone whose home conditions don't meet the diagnostic criteria, but who no longer receive visits from family or friends because of the state of their house.) b) The diagnostic criteria to a large extent represent a traditional, common-sense, real-world societal view - i.e. it's fine to collect things, until it starts to make you unwell, and unsafe in your physical environment. c) The diagnostic criteria are updated seldom, and slowly. [1] As such, it's not infeasible that DSM-5 might lag behind (potential, arguable) alternate forms of hoarding disorder - such as digital hoarding. Consider someone who spends huge amounts of money on storage media and electricity, to the detriment of their financial well-being and maybe close relationships. Or someone who spends so much of their time downloading and categorising their digital belongings, that they miss sleep and make themselves unwell, or avoid social engagement and have detrimental effects on close relationships. These cases might not be diagnosable within DSM-5, but I'd argue that they would still be representative of psychopathology... and may in time (in DSM-7? :) ) be diagnosable in their own right. [0] https://www.ncbi.nlm.nih.gov/books/NBK519704/table/ch3.t29/ https://www.ncbi.nlm.nih.gov/books/NBK519704/table/ch3.t29/ [1] https://www.psychiatry.org/psychiatrists/practice/dsm https://www.psychiatry.org/psychiatrists/practice/dsm