Dr. Amdur suggests that compulsive hoarders may not meet DSM-IV-TR criteria for OCD because they appear to suffer more from their inaction than from repetitive behaviors. However, compulsive hoarders have been found to have many repetitive acquisition and saving behaviors (3). While DSM-IV-TR does not explicitly mention compulsive hoarding as a symptom of OCD, hoarding and saving-related obsessions and compulsions are quite common in patients with OCD (4, 5) and are included in standard OCD assessments, such as the Yale-Brown Obsessive Compulsive Scale symptom checklist (6). Dr. Amdur observes that compulsive hoarders do not appear to have anxiety unless they are threatened by forced clearing, but several studies have found elevated anxiety levels in compulsive hoarders, even in comparison to nonhoarding OCD patients (7, 8). Moreover, hoarders also report a high prevalence of nonhoarding obsessions and compulsions (2, 3) and do not differ from nonhoarding OCD patients in the number of OCD symptoms reported on the Yale-Brown Obsessive Compulsive Scale checklist or overall score (7, 8).