On arrival to the property, the police officers noticed a strong-smelling odour coming from underneath the front door, and upon looking through the door windowpanes, could see flies on the other side. Attempts were made to raise the man's attention by knocking loudly on the front door, but there was no response. It was reported that the man had not been seen or heard from in 3 weeks and that there was a large pile of unopened mail outside his door. Police officers attended the man's home following the alarm being raised by his stepfather regarding his welfare. Written informed consent was obtained from the patient and formally witnessed, both prior to writeup and submission for publication. This case report offers a rare opportunity to better understand the distinction of Diogenes syndrome from hoarding disorder.Ī 51-year-old male was admitted to the hospital psychiatric ward following the police removing him from his home and taking him to the emergency room, where he was seen by the staff and assessed by the on-call psychiatrist. The literature reveals Diogenes syndrome to be highly comorbid with various psychiatric and somatic disorders, including depression, obsessive-compulsive disorder, personality disorder, and stress.
Indeed, the conditions leading to the hospitalisation and treatment of the patient reported in this case appeared circumstantially suggestive of hoarding disorder. The importance of clear diagnostic criteria and classification is imperative to diagnose Diogenes accurately (for case examples highlighting the complexity and diversity of patients that may be incorrectly labelled as having Diogenes, see Lee and LoGiudice, 2012.). As noted by Lee and LoGiudice, the passive accumulation of rubbish and “failure to remove household waste is strictly speaking a form of neglect rather than hoarding” (p. )-Diogenes is distinct from hoarding disorder, with the presence of squalor and neglect, without insight, distress, or emotional attachment differentiating it from syllogomania.
#Bathtub diogenes syndrome manual
The current Diagnostic and Statistical Manual of Mental Disorders 5th Edition ( DSM-5) does not list Diogenes syndrome as a psychiatric condition however, it includes the closely related condition hoarding disorder ( C.R. Symptoms have been noted to include the following: extreme self-neglect of environment, health, and hygiene, excessive/abnormal hoarding (syllogomania), living in squalor, social withdrawal/living reclusively, refusal of help, and a distinct lack of concern and shame regarding one's living condition. Clark, Mankikar, and Gray coined the term Diogenes syndrome, replacing the earlier term senile squalor syndrome. Extant case studies identify and describe the condition as “severe domestic squalor,” with some arguing that this is a better descriptor of the syndrome ( C.R. The etiopathogenesis of Diogenes syndrome remains unclear, with little consensus regarding the diagnostic criteria. Furthermore, creating an agreed-upon constellation of symptoms representative of Diogenes is essential to creating a formal Diagnostic and Statistical Manual of Mental Disorders (DSM) entry, which would facilitate the much-needed development of assessment measures to enable accurate diagnosis and treatment. This case report provides a rare opportunity to better understand the distinction of Diogenes syndrome from the closely related condition hoarding disorder. Diogenes syndrome is highly comorbid with psychiatric and somatic disorders, including depression, obsessive-compulsive disorder, personality disorder, and stress. He was found lying nude on top of garbage with a rug over him. His home was covered in several feet of rubbish, rotting food, and debris and smelled intensely of rotting mould, urine, and faeces. Police officers attended the man's home following the alarm being raised by his stepfather that he had not been seen or heard from in 3 weeks. This report presents a case of a 51-year-old male admitted to the hospital psychiatric ward following the police removing him from his home. “Severe domestic squalor” or Diogenes syndrome is characterised by extreme self-neglect of environment, health, and hygiene, excessive hoarding, squalor, social withdrawal, and a distinct lack of concern or shame regarding one's living condition.
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