Diogenes syndrome - causes and treatment of pathological hoarding and self neglect
DOI:
https://doi.org/10.12775/JEHS.2024.58.015Keywords
Diogenes syndrome, Diogenes’ syndrome, squalor, bvFTD, hoardingAbstract
Introduction
Diogenes syndrome is a behavioral disorder typically described in physically neglected people living in extreme poverty, unsanitary conditions and self-imposed isolation, who often refuse outside help and tend to accumulate unusual objects. This syndrome is gaining increasing attention in the world of neurology and psychiatry.
The aim of the study
To summarize current knowledge on the causes of Diogenes syndrome, its characteristics and treatment.
Material and methods
The search of the Pubmed and Google Scholar database was carried out using keywords, in order to find the latest publications.
Summary
Diogenes syndrome is a complex disease that will affect an increasing number of elderly people as the population ages. There is a lack of extensive research to create clear diagnostic criteria, classification and treatment for Diogenes syndrome. The creation of a disease entity would enable earlier diagnosis and help patients.
References
Sacchi L, Rotondo E, Pozzoli S, et al. Diogenes syndrome in dementia: a case report. BJPsych Open. 2021;7(2):e43. Published 2021 Feb 2. doi:10.1192/bjo.2020.171
Finney CM, Mendez MF. Diogenes Syndrome in Frontotemporal Dementia. Am J Alzheimers Dis Other Demen. 2017;32(7):438-443. doi:10.1177/1533317517717012
Cipriani G, Lucetti C, Vedovello M, Nuti A. Diogenes syndrome in patients suffering from dementia. Dialogues Clin Neurosci. 2012;14(4):455-460. doi:10.31887/DCNS.2012.14.4/gcipriani
Macmillan D, Shaw P. Senile breakdown in standards of personal and environmental cleanliness. Br Med J. 1966;2(5521):1032-1037. doi:10.1136/bmj.2.5521.1032
Proctor C, Rahman S. Diogenes Syndrome: Identification and Distinction from Hoarding Disorder. Case Rep Psychiatry. 2021;2021:2810137. Published 2021 Nov 25. doi:10.1155/2021/2810137
Khan S. Diogenes syndrome: a special manifestation of hoarding disorder. The American Journal of Psychiatry . 2017;12(8):9–11. doi: 10.1176/appi.ajp-rj.2017.120804
Ashworth F, Rose A, Wilson BA. TD: The case of Diogenes Syndrome-deficit or denial?. Neuropsychol Rehabil. 2018;28(2):244-258. doi:10.1080/09602011.2017.1391104
Irvine JD, Nwachukwu K. Recognizing Diogenes syndrome: a case report. BMC Res Notes. 2014;7:276. Published 2014 May 2. doi:10.1186/1756-0500-7-276
Zuliani G, Soavi C, Dainese A, Milani P, Gatti M. Diogenes syndrome or isolated syllogomania? Four heterogeneous clinical cases. Aging Clin Exp Res. 2013;25(4):473-478. doi:10.1007/s40520-013-0067-0
American Psychiatric A, Force DSMT. Diagnostic and Statistical Manual of Mental Disorders: DSM-5. 2013;
Snowdon J. Squalor syndrome. J Am Geriatr Soc. 1997;45(12):1539-1540. doi:10.1111/j.1532-5415.1997.tb03216.x
Lee SM, Martino E, Bismark M, Bentley R. Evidence to guide ethical decision-making in the management of older people living in squalor: a narrative review. Intern Med J. 2022;52(8):1304-1312. doi:10.1111/imj.15862
Clark AN, Mankikar GD, Gray I. Diogenes syndrome. A clinical study of gross neglect in old age. Lancet. 1975;1(7903):366-368. doi:10.1016/s0140-6736(75)91280-5
Halliday G, Snowdon J, Simpson B. Re: Diogenes syndrome in a pair of siblings. Can J Psychiatry. 2005;50(9):567. doi:10.1177/070674370505000914
Monfort JC, Hugonot-Diener L, Devouche E, Wong C, Péan I. Le syndrome de Diogène et les situations apparentées d'auto-exclusion sociale. Enquête descriptive [Diogenes's syndrome: an observatory study in a Paris district]. Psychol Neuropsychiatr Vieil. 2010;8(2):141-153. doi:10.1684/pnv.2010.0215
Ferry P. A case of Diogenes syndrome. The Journal of Malta College of Family Doctors . 2013;2(3):29–31.
Gama Marques J. Diogenes Syndrome in a Homeless Man With the Westphal Variant of Huntington's Disease. Prim Care Companion CNS Disord. 2023;25(2):22cr03283. Published 2023 Mar 2. doi:10.4088/PCC.22cr03283
Mendez MF, Shapira JS, Saul RE. The spectrum of sociopathy in dementia. J Neuropsychiatry Clin Neurosci. 2011;23(2):132-140. doi:10.1176/jnp.23.2.jnp132
Anderson SW, Damasio H, Damasio AR. A neural basis for collecting behaviour in humans. Brain. 2005;128(Pt 1):201-212. doi:10.1093/brain/awh329
Perry DC, Whitwell JL, Boeve BF, et al. Voxel-based morphometry in patients with obsessive-compulsive behaviors in behavioral variant frontotemporal dementia. Eur J Neurol. 2012;19(6):911-917. doi:10.1111/j.1468-1331.2011.03656.x
Figee M, Wielaard I, Mazaheri A, Denys D. Neurosurgical targets for compulsivity: what can we learn from acquired brain lesions?. Neurosci Biobehav Rev. 2013;37(3):328-339. doi:10.1016/j.neubiorev.2013.01.005
Mitchell E, Tavares TP, Palaniyappan L, Finger EC. Hoarding and obsessive-compulsive behaviours in frontotemporal dementia: Clinical and neuroanatomic associations. Cortex. 2019;121:443-453. doi:10.1016/j.cortex.2019.09.012
Harrison BJ, Pujol J, Cardoner N, et al. Brain corticostriatal systems and the major clinical symptom dimensions of obsessive-compulsive disorder. Biol Psychiatry. 2013;73(4):321-328. doi:10.1016/j.biopsych.2012.10.006
Subirà M, Cano M, de Wit SJ, et al. Structural covariance of neostriatal and limbic regions in patients with obsessive-compulsive disorder. J Psychiatry Neurosci. 2016;41(2):115-123. doi:10.1503/jpn.150012
Yamada S, Nakao T, Ikari K, et al. A unique increase in prefrontal gray matter volume in hoarding disorder compared to obsessive-compulsive disorder. PLoS One. 2018;13(7):e0200814. Published 2018 Jul 16. doi:10.1371/journal.pone.0200814
Mitchell E, Tavares TP, Palaniyappan L, Finger EC. Hoarding and obsessive-compulsive behaviours in frontotemporal dementia: Clinical and neuroanatomic associations. Cortex. 2019;121:443-453. doi:10.1016/j.cortex.2019.09.012
Gama Marques J. Diogenes, Plyushkin, or Havisham Syndrome? Syllogomania (hoarding with squalor) Secondary to Left Cerebellopontine Angle Giant Benign Transitional Meningioma. Prim Care Companion CNS Disord. 2022;24(5):21cr03219. Published 2022 Oct 13. doi:10.4088/PCC.21cr03219
Lee SM, Lewis M, Leighton D, Harris B, Long B, Macfarlane S. Neuropsychological characteristics of people living in squalor. Int Psychogeriatr. 2014;26(5):837-844. doi:10.1017/S1041610213002640
Waserman JE, Hategan A, Bourgeois JA. Harnessing neuroplasticity in Diogenes syndrome: a proposed mechanism to explain clinical improvement. Gen Hosp Psychiatry. 2014;36(6):761.e3-761.e761005. doi:10.1016/j.genhosppsych.2014.06.013
Saxena S, Brody AL, Maidment KM, Baxter LR Jr. Paroxetine treatment of compulsive hoarding. J Psychiatr Res. 2007;41(6):481-487. doi:10.1016/j.jpsychires.2006.05.001
Gálvez-Andres A, Blasco-Fontecilla H, González-Parra S, Molina JD, Padín JM, Rodriguez RH. Secondary bipolar disorder and Diogenes syndrome in frontotemporal dementia: behavioral improvement with quetiapine and sodium valproate. J Clin Psychopharmacol. 2007;27(6):722-723. doi:10.1097/JCP.0b013e31815a57c1
Millen AM, Levinson A, Linkovski O, et al. Pilot Study Evaluating Critical Time Intervention for Individuals With Hoarding Disorder at Risk for Eviction. Psychiatr Serv. 2020;71(4):405-408. doi:10.1176/appi.ps.201900447
Ayers CR, Bratiotis C, Saxena S, Wetherell JL. Therapist and patient perspectives on cognitive-behavioral therapy for older adults with hoarding disorder: a collective case study. Aging Ment Health. 2012;16(7):915-921. doi:10.1080/13607863.2012.678480
Ayers CR, Dozier ME, Twamley EW, et al. Cognitive Rehabilitation and Exposure/Sorting Therapy (CREST) for Hoarding Disorder in Older Adults: A Randomized Clinical Trial. J Clin Psychiatry. 2018;79(2):16m11072. doi:10.4088/JCP.16m11072
Chou CY, Tsoh JY, Shumway M, et al. Treating hoarding disorder with compassion-focused therapy: A pilot study examining treatment feasibility, acceptability, and exploring treatment effects. Br J Clin Psychol. 2020;59(1):1-21. doi:10.1111/bjc.12228
Snowdon J. Severe domestic squalor: Time to sort out the mess. Aust N Z J Psychiatry. 2014;48(7):682-684. doi:10.1177/0004867414533160
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2024 Julia Czarnota-Kuczyńska, Katarzyna Cichoń, Małgorzata Chyćko, Natalia Trąbka, Gabriela Demidowicz, Martyna Younes, Nina Lasota, Wojciech Wiśniewski, Maciej Lambach, Klaudia Kowalczyk
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
The periodical offers access to content in the Open Access system under the Creative Commons Attribution-NonCommercial-ShareAlike 4.0
Stats
Number of views and downloads: 245
Number of citations: 0