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Diogenes Syndrome: more than just living in garbage

Diogenes Syndrome: more than just living in garbage

The Diogenes syndrome is a behavioral disorder in which the person (usually of advanced age) stops taking care of himself and presents a severe self-abandonment. It shows social isolation, accumulation of large quantities of objects and garbage, and can live in truly unhygienic conditions.

Content

  • 1 Who suffers Diogenes Syndrome?
  • 2 Primary and secondary Diogenes syndrome
  • 3 Signs and symptoms of Diogenes Syndrome
  • 4 Treatment of Diogenes Syndrome

Who suffers Diogenes Syndrome?

Although the Diogenes syndrome is mainly observed in older people, can affect men and women of any age and socioeconomic status.

However, it is described that Diogenes syndrome is more common among people with higher than average intelligence, who are over 60 years old and who live alone.

Approximately 0.05% of people over 60 can suffer from Diogenes Syndrome. It is considered rare, but there is a lack of research on its prevalence.

Primary and secondary Diogenes syndrome

In the primary cases, the syndrome is not caused by other medical conditions, it is a unique behavioral disorder. In the secondary casesThe syndrome is the result of other mental health disorders, such as dementia.

Signs and symptoms of Diogenes Syndrome

The symptoms are very variable, but there are a set of common characteristics that are usually present and are the following:

  • Little awareness of illness, understanding of self-hygiene, public health and safety
  • Distrust of strangers
  • Paranoia and mistrust in general
  • Distance and voluntary isolation
  • Extreme social anxiety
  • Obsessive-compulsive tendencies
  • Excessive hoarding of household items and waste
  • Unsanitary or unsafe living conditions
  • Bad nutrition
  • Lack of willingness to accept external help or intervention
  • Fear or distrust of medical professionals
  • Hostility and aggression towards others
  • Distorted reality concept
  • Skin diseases due to lack of cleanliness, such as passivata dermatitis

The signs and symptoms of Diogenes Syndrome are often difficult to distinguish from those of other disorders such as:

  • Accumulation disorder (Syllogomania)
  • Schizophrenia
  • Mania
  • Frontotemporal dementia
  • Depression
  • Obsessive-compulsive personality disorder
  • Alcoholism

Research is still underway to improve understanding of Diogenes Syndrome.

Most of what is known about this disorder is based on psychological case studies. Some sources estimate that at least half of all cases occur in patients without previous mental health conditions.

When it is not associated with any other medical condition, Diogenes Syndrome It can be caused by a traumatic or stressful event, like the death of a loved one.

During the grieving period, daily activities such as personal care tend to be interrupted or overlooked. Lack of self-care, extreme social isolation and abandonment tend to distinguish Diogenes Syndrome from Accumulation Disorder.

Because little specific research available, health, and social mental complications related to Diogenes syndrome are not well known.

Diogenes Syndrome Treatment

There is no diagnostic plan or standard treatment for Diogenes Syndrome.

Some studies recommend the compilation of the medical and psychological history of the patient, in addition to performing a complete physical examination to check their general health.

Personality assessments are carried out in case they can shed light on the cause of the syndrome.

Some doctors may also perform imaging tests to rule out the presence of other diseases that may be causing similar symptoms.

Nowadays there are no medications or therapy options recognized or recommended specifically for the treatment of Diogenes Syndrome. Some medications designed or prescribed to treat other medical conditions can help relieve symptoms, such as paranoia or mania.

Psychological factors must also be taken into account, as they often lead to the development or continuation of the syndrome. Psychological therapy and counseling is necessary.

Treatments work best alongside other support systems designed to treat the underlying cause of the syndrome. For example, cleaning and personal care services can help reduce the severity of symptoms.

As we have already explained, people with Diogenes Syndrome are often fearful of medical and health advice. For this reason, ethical and legal norms can complicate the treatment that patients already persist in their attitude. refuse medical intervention.

Because there are different views on self-hygiene and safety depending on people and cultures, many of the symptoms of Diogenes Syndrome can also be difficult to assess and treat objectively.

Diogenes Syndrome cases should be handled with extreme sensitivity by all therapists. If a patient feels attacked, judged or insecure as a result of the intervention, he will be much more likely to refuse new help and return to his previous behavior.

References

Furtos J: Psychosocial approach of Diogenes syndrome. Soins Psychiatr 2015; (298): 17-20

Nayak K, Gopinath H, Kini H, et al. : Unmasking Diogenes syndrome. Indian J Dermatol 2015; 60 (3): 287-289

American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 4th ed. Text review Washington, DC: American Psychiatric Association. 2000

World Health Organization. ICD-10 classification of mental and behavioral disorders. Clinical descriptions and diagnostic guides. Geneva, Switzerland: WHO. 1992

Jackson GA Diogenes syndrome: how should we handle it? J Ment Health. 1997; 6: 113-117

Badr A., ​​Hossain A., Iqbal J. Diogenes syndrome: when self-abandonment is almost fatal. Clin Geriatr. 2005; 13: 10-13

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