From Physical to Digital: Hoarding Phenomena in Obsessive-Compulsive Disorder

In the era of digitalization, digital hoarding is a behavioral concern in psychiatry. It involves excessive accumulation of digital information, coupled with persistent difficulty discarding files, leading to interference with daily functioning.¹ Individuals often experience urges to retain files due to perceived future utility or sentimental attachment, mirroring physical hoarding.² Despite growing recognition in human-computer interaction research, digital hoarding remains underexplored in clinical psychiatric literature, particularly in relation to obsessive-compulsive disorder (OCD).

Case Report

An 18-year-old male from a middle socioeconomic background presented with complaints of intrusive thoughts regarding cleanliness, repetitive overwriting, excessive time spent arranging, compulsive collecting of large volumes of digital content, and irritability for the past 5 years. Family history included OCD in his sister and physical hoarding in his father.

He spent 10–13 hours daily on his mobile phone. He had stored 90,000 screenshots, systematically organized by theme, and maintained 8 to 9 social media accounts, saving 15,000 posts across accounts dedicated to themes like astrology, spirituality, Vastu Shastra, and mythology. He described a persistent urge to accumulate “just in case” they might be useful and experienced marked distress at the thought of deletion.

His hoarding extended to online shopping platforms, where he had filled the maximum number of “wishlist” items (1,000). He frequently fought with his siblings over shared device use. Academically, impaired concentration and repetitive overwriting led to school dropout in class 9.

On mental status examination, he exhibited an anxious affect, with obsessive fears about losing digital data and compulsive urges to organize into folders. A diagnosis of OCD was made with a Yale-Brown Obsessive-Compulsive Scale³ (Y-BOCS) score of 32, indicating severe symptomatology, and a Brown Assessment of Beliefs Scale⁴ score of 5, indicating good insight.

He was started on sertraline 300 mg/d with minimal improvement. It was cross-tapered with fluvoxamine, optimized to 300 mg/d. Risperidone 3 mg/d was added for augmentation. Cognitive-behavioral therapy (CBT) with exposure and response prevention was planned; however, due to frequent anger outbursts, CBT was temporarily deferred. Structured anger management was initiated, and CBT was reintroduced.

Gradually, the patient’s mobile phone use declined to 1 to 2 hours, screenshot taking ceased, and arranging behaviors decreased. His Y-BOCS score improved to 14.

Discussion

This case illustrates how hoarding phenomenology can manifest in digital environments. The patient’s behaviors reflected classical hoarding-related cognitions, such as “just in case” saving and difficulty discarding possessions, expressed digitally. Phenomenologically, these behaviors mirror the acquisition and retention patterns seen in physical hoarding but are facilitated by unique features of the digital environment: virtually unlimited storage, anonymity, and low visibility.

Personal information management describes how individuals collect, store, and organize digital material and is typically adaptive.⁵ However, in OCD, excessive reliance on categorization and decision-making may foster maladaptive “digital cluttering.”⁶ CBT models of hoarding suggest that indecisiveness, perfectionism, and emotional attachment to possessions contribute to difficulty discarding, also evident in our patient.²

Clinically, digital hoarding may be less visible than physical hoarding but can be equally impairing, reducing productivity, compromising attention, and posing cybersecurity risks.⁶ Treatment of hoarding symptoms in OCD is challenging. High-dose selective serotonin reuptake inhibitors with antipsychotic augmentation are commonly employed. CBT, particularly with exposure and response prevention and discarding exercises, remains the first-line intervention.⁷

Conclusion

Digital hoarding is an emerging behavioral concern within the OCD spectrum. Clinicians should inquire specifically about digital accumulation during psychiatric assessments.

In the Indian context, digital accumulation may be shaped by sociocultural values. This case underscores the importance of culturally informed assessment and interpretation of digital behaviors. Longitudinal studies are needed to elucidate its phenomenology, and clinical trials should explore how CBT protocols can be tailored to address digital hoarding.

Article Information

Published Online: May 14, 2026. https://doi.org/10.4088/PCC.25cr04153
© 2026 Physicians Postgraduate Press, Inc.
Prim Care Companion CNS Disord 2026;28(3):25cr04153
Submitted: November 27, 2025; accepted January 21, 2026.
To Cite: Khatri MA, Naskar I, Kumar S, et al. From physical to digital: hoarding phenomena in obsessive-compulsive disorder. Prim Care Companion CNS Disord 2026;28(3):25cr04153.
Author Affiliations: Central Institute of Psychiatry, Ranchi, Jharkhand, India (Khatri, Paliwal, Mehta); Department of Psychiatry, All India Institute of Medical Sciences, Kalyani, West Bengal, India (Naskar); Private Practice, Ranchi, Jharkhand, India (Kumar).
Corresponding Author: Indira Naskar, MBBS, MD, Department of Psychiatry, All India Institute of Medical Sciences, Kalyani, West Bengal, India ([email protected]).
Financial Disclosure: None.
Funding/Support: None.
Patient Consent: Written informed consent was received from the patient to publish the case report, and information has been de-identified to protect patient anonymity.
ORCID: Indira Naskar: https://orcid.org/0009-0000-1714-5554; Varun Shantilal Mehta: https://orcid.org/0000-0002-9308-4754