title: Two types of squalor: findings from a factor analysis of the Environmental Cleanliness and Clutter Scale (ECCS).
abstract: BACKGROUND
  Most people who collect and hoard, and then have difficulty discarding items, do not live in squalor, even though accumulation of hoarded items can make cleaning very difficult. Commonly, people living in squalor accumulate garbage, but relatively few fulfill proposed criteria for "hoarding disorder." We examined the overlap between hoarding and squalor among people referred because of unacceptable living conditions.
  
  
  METHODS
  Ongoing collection of data by a Squalor Project team, including ratings on the Environmental Cleanliness and Clutter Scale (ECCS), allowed (1) description of characteristics of cases and (2) examination of ratings of uncleanliness, and of the effect of accumulation of items or material on access within dwellings. Principal component analysis was used to examine latent variables underlying the ECCS.
  
  
  RESULTS
  The mean age of the referred occupants (108 male, 95 female) was 61.9 years. The mean ECCS score in 186 rated cases was 18.5. Factor analysis of ECCS data showed a two-factor solution as the most plausible. Factor 1, comprising seven squalor items, accounted for 33.7% of the variance. Factor 2 comprised reduced accessibility and accumulation of items of little value (variance 17.6%). Accumulation of garbage loaded equally on the two factors. High levels of squalor and/or accumulation were recorded in 105 (56%) of the 186 dwellings. One-third scored high on accumulation/hoarding, while 38% scored high on squalor; 15% scored high on both squalor and accumulation. A quarter of those scoring high on squalor scored low on hoarding/accumulation.
  
  
  CONCLUSIONS
  The ECCS is useful when describing whether referred cases show high levels of squalor, hoarding, or both.
authors.affiliation: Discipline of Psychiatry, Sydney Medical School, and Old Age Psychiatrist, Sydney Local Health District, Concord Hospital, Sydney, NSW 2139, Australia. jsnowdon@mail.usyd.edu.au
authors.forename: John
authors.initials: J
authors.lastname: Snowdon
authors.forename: Graeme
authors.initials: G
authors.lastname: Halliday
authors.forename: Glenn E
authors.initials: GE
authors.lastname: Hunt
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003153:Community Health Services; D004777:Environment; D005163:Factor Analysis, Statistical; D005260:Female; D000067836:Hoarding Disorder / Q000523:psychology*; D006801:Humans; D006920:Hygiene; D008297:Male; D008875:Middle Aged; D009771:Obsessive-Compulsive Disorder / Q000175:diagnosis / Q000523:psychology*; D025341:Principal Component Analysis; D012931:Social Environment; D011795:Surveys and Questionnaires