Noah syndrome: How to help animal hoarders

By Jules Murtha | Medically reviewed by Kevin Kennedy, MD
Published October 20, 2022

Key Takeaways

  • Noah syndrome—also known as animal hoarding disorder—is a variant of Diogenes syndrome.

  • Research states that patients who have Noah syndrome hoard animals in uninhabitable conditions and often deal with loneliness, psychosocial stress, and psychopathology.

  • Doctors primarily rely on cognitive behavioral therapies and antidepressants to treat patients with hoarding disorders. Community interventions with solution-focused approaches may also prove effective.

Healthcare workers discovered an additional health crisis when assessing an 83-year-old widow who fell in her home. She had 15 dogs and 16 cats, all malnourished. Her house was filthy, infested with cockroaches and flies; her personal hygiene was also poor.

As reported in the Journal of Elderly Abuse & Neglect, she was diagnosed with Noah syndrome, which can be treated with cognitive behavioral therapies, medications, and community-based interventions, although few formal treatment studies exist.[]

What is Noah syndrome?

Noah syndrome is a type of Diogenes syndrome that is characterized by animal hoarding.

Individuals with Noah syndrome tend to hoard animals in conditions that cannot support the animals’ (or patient’s) well-being.

A case study published in 2022 by The Primary Care Companion reported that patients with Noah syndrome may be predisposed to it as a result of living with psychosocial stress, loneliness, and other psychopathologies rooted in neurologic or psychiatric illnesses.[]

One patient, a 56-year-old man with intellectual disability and organic psychosis, also showed signs of Noah syndrome. He lived alone in a poor rural area and used his income to purchase new birds each month.

Despite the growing number of birds he acquired, the patient continually failed to care for them. The birds were on the brink of death, living in soiled birdcages and suffering from neglect.

The patient also exhibited poor hygiene, and he kept plastic bottles containing urine throughout his house.

His physical and mental condition declined after his mother (who helped him manage his animal hoarding) died 3 years prior.

Individuals with Noah syndrome may resist help from professionals—which is exactly what this patient did when his primary caretaker offered assistance. Noah syndrome can therefore pose real dangers to people who suffer with it.

Prevalence and diagnostics

Also known as animal hoarding disorder (AHD), Noah syndrome is considered to be underestimated in terms of prevalence. According to a 2020 systematic review published by Human-Animal Interaction Bulletin, many cases go unreported due to the seclusive nature of those who have it.[]

Patients with AHD are usually in their 50s or 60s; most (3:1) are also women. Research has failed to show any notable differences in hoarding styles or severity of symptoms based on sex, however.

The authors of the Human-Animal Interaction Bulletin review elaborated on what doctors can expect from patients who suffer from AHD.

"Besides sanitation hazards, AHD cases tend to involve animal cruelty."

Nadal, et al.

“This is one of the main reasons for complaint among neighbors, and it is key to identify[ing] AHD situations,” the authors continued. “Cruelty is normally defined as neglect in basic care, decay of living conditions, absence of attention to basic needs in nutrition and hygiene, overcrowding and poor health, lack of veterinary care or even cohabitation with dead animals, all typical settings for animals in cases of AHD.”

Exploring treatment options

Hoarding disorders are treatable, although the outcomes appear to be poorer than with other psychiatric conditions. Clinicians can employ CBT, as noted in an article published by the Cleveland Clinic.[] Through CBT, patients can uncover the reasons driving them to hoard, as well as how to manage anxious feelings that come up when they start tossing items.

Physicians can also prescribe antidepressants to patients with hoarding disorders such as AHD.

They may lessen the symptoms’ severity, but there is relatively little research on this topic.

You may also treat patients who have Noah syndrome/AHD with a community-based intervention, according to The Primary Care Companion.

Although further research is needed to confirm the efficacy of this approach, experts say that preparing the patient’s community to engage in a collaborative, solution-focused intervention may lead to positive results.

What this means for you

Noah syndrome—also called AHD—is a subset of Diogenes syndrome, both of which usually occur in middle-aged or elderly patients. Those who have it tend to hoard animals they fail to properly care for. Patients with this illness usually struggle with psychosocial stress, loneliness, and other neurologic and psychiatric disorders. Since it’s a form of hoarding disorder, you may treat patients with Noah syndrome using CBT and antidepressants, but research studies to determine effective treatments are ongoing.

Read Next: Hoarding symptoms are associated with higher rates of disability than other medical and psychiatric disorders across multiple domains
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