Diogenes syndrome

GC: n

S: HLRL – https://goo.gl/uGvrjG (last access: 2 November 2017); HIN – https://www.hindawi.com/journals/cridm/2013/595192/ (last access: 2 November 2017).

N: 1. Diogenes syndrome is an eponymous created from two words:

  • Diogenes: Diogenes of Sinope (c. 404-323 BCE) was a Greek Cynic philosopher best known for holding a lantern (or candle) to the faces of the citizens of Athens claiming he was searching for an honest man.
  • syndrome: “a number of symptoms occurring together,” 1540s, from medical Latin, from Greek syndrome “concurrence of symptoms, concourse of people,” from syndromos “place where several roads meet,” literally “a running together,” from syn- “with” + dromos “a running, course”. Psychological sense is from 1955.

2. Acronym: DS.
3. History of the term:

  1. The eponym was first suggested in 1975 by Clark and collaborators, who described 30 geriatric patients with personalities characterized by suspiciousness, aloofness, hostility, and unfriendliness admitted to hospital in a state of severe self-neglect, and who were living in gross domestic squalor.
  2. MacMillan and colleagues (1966) who conducted the first thorough investigation, called the syndrome senile breakdown. It is also known as the self-neglect syndrome, senile squalor or social withdrawal one.
  3. In 1982, the term senile recluse appeared and argued that it is not a syndrome but merely an end stage of personality disorder.
  4. Nowadays, the syndrome has been defined as a ”failure of social and personal care, reflecting a psychiatric point of view.

4. Diogenes syndrome is a behavioral disorder of the elderly which symptoms include: living in extreme squalor, a neglected physical state, and unhygienic conditions. This is accompanied by a self-imposed isolation, the refusal of external help, and a tendency to accumulate unusual objects.
5. The syndrome is not listed in current classifications of diseases such as DSM-IV-TR (Diagnostic and Statistical Manual of Mental Disorders, 4th edition, text revision), DSM-5 Draft Criteria, or ICD-10 (International Statistical Classification of Diseases and Related Health Problems, 10th edition),since the features of this disorder are included in many diagnoses, but not as a specific disease.
6. The estimated annual incidence of Diogenes syndrome is 0.5 per 1000 of the population aged 60 or over living at home. Some of them may go unrecognized because it may mimic other behavioral or cognitive disorders.The age range in the Clark et al study is of 66 to 92 years (average, 79 years), although younger individuals have been described: 30.9% of cases in a selected sample was below 65 years of age. According to Shah and Reyes-Ortiz, the syndrome is not specific to a certain socioeconomic status or profession, and appears to be equally prevalent among men and women.
7. Phases of Diogenes syndrome:

  • Never ask for any help despite possessing nothing
  • Unusually fond of certain objects (including rubbish)
  • Display unusual behavior with other people (misanthropy)
  • Display extreme self-neglect.

8. Diferences between OCD (obsessive-compulsive disorder) and Diogenes syndrome:

  • Compulsive hoarding is a form of obsessive-compulsive disorder (OCD) that is characterized by excessive acquisition of possessions, inability to discard possessions, and excessive clutter. Patients usually display other obsessive features, feel distress if they cannot hoard objects, show a typical cognitive pattern with obsessive features, and their interpersonal relations are mediated by objects.
  • Diogenes syndrome is the combination of severe self-neglect, domestic squalor, social withdrawal, hoarding, and refusal of help, in elderly patients. There is high comorbidity with psychiatric/somatic disorders.

9. Cultural Interrelation:
– Reality: One famous story of self-neglect and hoarding is the story of the Collyer brothers, Homer and Langley. In March 1947, police entered their Harlem mansion to investigate reports of a dead body in the home. Indeed, they found Homer Collyer dead from starvation in the midst of decades of compulsive hoarding. The house was filthy and in ill repair. It was rigged with a series of booby traps. Two weeks after finding Homer’s body and after the removal of more than 130 tons of stuff, the body of Homer’s brother, Langley was found. He apparently had been asphyxiated when one of his own booby traps had crushed him under mountains of debris.

S: 1. OED – https://www.etymonline.com/word/syndrome (last access: 2 November 2017); AEU – https://www.ancient.eu/Diogenes_of_Sinope/ (last access: 2 November 2017). 2 to 6. PMH/AC – https://goo.gl/8RijNA (last access: 2 November 2017). 7. PT – https://goo.gl/ZEP6gx (last access: 2 November 2017). 8. PMH – https://goo.gl/N2etr8 (last access: 2 November 2017). 9. DWI – https://goo.gl/S8nRwS (last access: 2 November 2017).

SYN: 1. self-neglect syndrome, senile breakdown syndrome, senile squalor syndrome o social breakdown syndrome. 2. extreme self neglect. (context)

S: 1. COSNAUTAS/LIBRO ROJO (last access: 2 November 2017). 2. PMH – https://goo.gl/8RijNA (last access: 2 November 2017).

CR: obsessive-compulsive disorder