The hoarders described in "Stuff: Compulsive Hoarding and the Meaning of Things" are at once fascinating and heartbreaking. Far from the clichés of pack rats and cat ladies, they are often deeply intelligent, creative people who see a beauty and utility in everyday objects that escapes most people. A charming gallery owner has an unstoppable habit of shopping for clothes, and an outgoing pair of twins adore fine art and take on extra apartment space to house it. But in those cases and many others, their affection turns into "creativity run amok," as Randy O. Frost and Gail Steketee put it. The fixation creates health hazards and destroys families, and municipalities' traditional response -- forced cleanouts -- not only fail to fix the problem but have left some hoarders distraught to the point of suicide.

Frost and Steketee are academics who have spent more than a decade studying hoarding, and though the source of the disorder is still largely a mystery, those who suffer share some psychological commonalities. Hoarders often experienced difficult childhoods, suffer from depression and are intense perfectionists. Guilt pervades any effort to dispose of even the least object, for fear of losing something useful. For instance, the authors successfully convince one hoarder to dispose of a ragged stuffed toy, but only after she photographed it multiple times and videotaped its departure. Afterward, she wrote a poem describing her feelings of loss -- toward an object she didn't much care about.

That's just a mild example. After opening with some relatively benign case studies of homes packed with newspapers and junk (with only narrow "goat trails" available to navigate between rooms), "Stuff" features some truly dire situations. A New Yorker forces his family to live in filth in a miserably overstuffed apartment, and a supervised cleanup gets him so overheated the police are called in. A woman who falls under the spell of a Svengali-like psychiatrist and cat hoarder winds up with her own poorly managed menagerie.

Finding solutions for hoarding is difficult, and in most of the cases Frost and Steketee describe, the hoarders become only slightly better at managing their compulsions. (In a sad irony, many have large collections of organizing bins and books on decluttering.)

The authors are scholars but not robotically so: Their examples are rich in storytelling and dialogue, and they admirably balance a fascination with the psychological profiles of their subject with a deep sympathy for their plights. "Hoarders are gifted with the ability to see the opportunities in so many things," they write. "They are equally cursed with the inability to let go of any of these possibilities." That can make for difficult reading at times, but the book is a valuable study of a poorly understood condition.

Mark Athitakis is a reviewer based in Washington, D.C. He blogs at americanfiction.wordpress.com.