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Diogenes



Diogenes
Diogenes syndrome
Other namesSenile squalor syndrome
Room crammed with garbage
SpecialtyPsychology, psychiatry

Diogenes syndrome, also known as senile squalor syndrome, is a disorder characterized by extreme self-neglect, domestic squalor, social withdrawal, apathy, compulsive hoarding of garbage or animals, plus lack of shame. Sufferers may also display symptoms of catatonia.[1][2]

The condition was first recognized in 1966[3] and designated Diogenes syndrome by Clark et al.[4] The name derives from Diogenes of Sinope, an ancient Greek philosopher, a Cynic and an ultimate minimalist, who allegedly lived in a large jar in Athens. Not only did he not hoard, but he actually sought human company by venturing daily to the Agora. Therefore, this eponym is considered to be a misnomer.[5][6][7] Other possible terms are senile breakdown, Plyushkin's Syndrome (after the Gogol character),[5]social breakdown and senile squalor syndrome.[8]Frontal lobe impairment may play a part in the causation (Orrell et al., 1989).[9]

Presentation[edit]

Diogenes is an environment for reading and searching through texts in Latin and Ancient Greek. It consists of two connected projects, the Diogenes desktop application, which has been in existence for nearly 20 years, and the new DiogenesWeb webapp.

Diogenes syndrome is a disorder that involves hoarding of rubbish and severe self-neglect. In addition, the syndrome is characterized by domestic squalor, syllogomania, social alienation, and refusal of help. It has been shown that the syndrome is caused as a reaction to stress that was experienced by the patient. The time span in which the syndrome develops is undefined, though it is most accurately distinguished as a reaction to stress that occurs late in life.[10][11]

In most instances, patients were observed to have an abnormal possessiveness and patterns of compilation in a disordered manner. These symptoms suggest damage to the prefrontal areas of the brain, due to its relation to decision making. In contrast, there have also been cases where the hoarded objects were arranged in a methodical manner, which may suggest a cause other than brain damage.

QuotesDiogenes laertius

Although most patients have been observed to come from homes with poor conditions, and many had been faced with poverty for a long period of time, these similarities are not considered a definite cause to the syndrome. Research showed that some of the participants with the condition had solid family backgrounds as well as successful professional lives. Half of the patients were of higher intelligence level.[12] This indicates the Diogenes syndrome does not exclusively affect those experiencing poverty or those who had traumatic childhood experiences.

  1. Diogenes Sarcastica™ is a tall but brilliant, fabulously talented and visually stunning example of a placental mammal, who takes the time from a career as a technical innovator in the recording industry and pretending to be a responsible adult, to daily opine about Politics & Culture on what is now the most widely read Louisiana based.
  2. Diogenes syndrome, also known as senile squalor syndrome, is a disorder characterized by extreme self-neglect, domestic squalor, social withdrawal, apathy, compulsive hoarding of garbage or animals, plus lack of shame.
  3. Diogenes of Sinope was a very playful philosopher who is said to have lived in ancient Greece between 412 -323 BC. He was an ascetic, begging his food and living in very poor conditions, with his greatest joy being to challenge people’s beliefs and values.

The severe neglect that they bring on themselves usually results in physical collapse or mental breakdown. Most individuals who suffer from the syndrome do not get identified until they face this stage of collapse, due to their predilection to refuse help from others.[4]

The patients are generally highly intelligent, and the personality traits that can be seen frequently in patients diagnosed with Diogenes syndrome are aggressiveness, stubbornness, suspicion of others, unpredictable mood swings, emotional instability and deformed perception of reality.[11] Secondary DS is related to mental disorders.[11] The direct relation of the patients' personalities to the syndrome is unclear, though the similarities in character suggest potential avenues for investigation.[11]

Diagnosis[edit]

Individuals suffering from Diogenes syndrome generally display signs of collectionism, hoarding, or compulsive disorder. Individuals who have suffered damage to the brain, particularly the frontal lobe, may be at more risk to developing the syndrome. The frontal lobes are of particular interest, because they are known to be involved in higher order cognitive processes, such as reasoning, decision-making and conflict monitoring.Diogenes Syndrome tends to occur among the elderly. The behavioural patterns that is usually reflected by those living with this disorder are suffering from significant functional problem that is correlated with morbidity and mortality.[13]

Management[edit]

It is ethically difficult when it comes to dealing with diagnosed patients, for many of them deny their poor conditions and refuse to accept treatment. The main objectives of the doctors are to help improve the patient’s lifestyle and wellbeing, so health care professionals must decide whether or not to force treatment onto their patient.

Diogenes Laertius

In some cases, especially those including the inability to move, patients have to consent to help, since they cannot manage to look after themselves. Hospitals or nursing homes are often considered the best treatment under those conditions.

When under care, patients must be treated in a way in which they can learn to trust the health care professionals. In order to do this, the patients should be restricted in the number of visitors they are allowed, and be limited to 1 nurse or social worker. Some patients respond better to psychotherapy, while others to behavioral treatment or terminal care.[11]

Diogenes Laertius

Results after hospitalization tend to be poor. Research on the mortality rate during hospitalization has shown that approximately half the patients die while in the hospital. A quarter of the patients are sent back home, while the other quarter are placed in long-term residential care. Patients under care in hospitals and nursing homes often slide back into relapse or face death.

There are other approaches to improve the patient’s condition. Day care facilities have often been successful with maturing the patient’s physical and emotional state, as well as helping them with socialization. Other methods include services inside the patient’s home, such as the delivery of food.[11]

History[edit]

The origin of the syndrome is unknown, although the term “Diogenes” was coined by A. N. G. Clarke et al. in the mid‑1970s and has been commonly used since then. Diogenes syndrome was acknowledged more prominently as a media phenomenon in popular media rather than medical literature. The primary description of this syndrome has only been mentioned recently by geriatricians and psychiatrists.[3][4]

Diogenes Syndrome

See also[edit]

References[edit]

  1. ^Cybulska, E; Rucinski, J (1986). 'Gross Self-neglect in Old Age'. Br J Hosp Med. 36 (1): 21–23. PMID3535960.
  2. ^Rosenthal, M; Stelian, J; Wagner, J; Berkman, P (1999). 'Diogenes syndrome and hoarding in the elderly: case reports'. The Israel Journal of Psychiatry and Related Sciences. 36 (1): 29–34. PMID10389361.
  3. ^ abMacmillan, D; Shaw, P. (1966). 'Senile breakdown in standards of personal and environmental cleanliness'. BMJ. 2 (5521): 1032–7. doi:10.1136/bmj.2.5521.1032. PMC1944569. PMID5919035.
  4. ^ abcClark, AN; Mankikar, GD; Gray, I (1975). 'Diogenes syndrome A clinical study of gross neglect in old age'. Lancet. 1 (7903): 366–368. doi:10.1016/S0140-6736(75)91280-5. PMID46514.
  5. ^ abCybulska, E (1998). 'Senile Squalor: Plyushkin's not Diogenes Syndrome'. Psychiatric Bulletin. 22 (5): 319–320. doi:10.1192/pb.22.5.319.
  6. ^(01-28-2006) by Alicia M. Canto, in: 'Uso y abuso de Diógenes'
  7. ^Marcos, M; Gomez-Pellin, MC. (2008). 'A tale of a misnamed eponym: Diogenes syndrome'. Int J Geriatr Psychiatry. 23 (9): 990–1. doi:10.1002/gps.2005. PMID18752218.
  8. ^Cooney, C; Hamid, W (1995). 'Review: diogenes syndrome'. Age and Ageing. 24 (5): 451–3. doi:10.1093/ageing/24.5.451. PMID8669353.
  9. ^Orrell, M; Sahakian, B. (1991). 'Dementia of frontal type'. Psychol Med. 21 (3): 553–6. doi:10.1017/S0033291700022170. PMID1946843.
  10. ^Hanon C, P. C. (2004). Diogenes Syndrome: A Transnosographic Approach. Encephale, 30 (4), 315-322.
  11. ^ abcdefReyes-Ortiz, C (2001). 'Diogenes syndrome: The self-neglect elderly'. Comprehensive Therapy. 27 (2): 117–121. doi:10.1007/s12019-996-0005-6. PMID11430258.
  12. ^Clark, AN; Mannikar (February 15, 1975). 'Diogenes syndrome. A clinical study of gross neglect in old age'. The Lancet. 1 (7903): 366–8. doi:10.1016/S0140-6736(75)91280-5. PMID46514.
  13. ^Cipriani, Gabriele; Claudio Lucetti; Marcella Vedovello; Angelo Nuti (14 December 2012). 'Diogenes syndrome in patients suffering from dementia'. Dialogues in Clinical Neuroscience. 14 (4): 455–460. PMC3553571. PMID23393422.

Further reading[edit]

  • Radebaugh, TS; Hooper, FJ; Gruenberg, EM. (1987). 'The social breakdown syndrome in the elderly population living in the community: the helping study'. Br J Psychiatry. 151 (3): 341–6. doi:10.1192/bjp.151.3.341. PMID3501323.
  • Shah, AK (1990). 'Senile squalour syndrome: what to expect and how to treat it'. Geriatr Med. 20: 10–26.
  • Wrigley, M; Cooney, C. (1992). 'Diogenes syndrome--an Irish series'. Ir J Psychol Med. 9: 37–41. doi:10.1017/S0790966700013896.
  • Snowdon, J. (1987). 'Uncleanliness among persons seen by community health workers'. Hosp Community Psychiatry. 38 (5): 491–4. doi:10.1176/ps.38.5.491. PMID3596484.
  • Berlyne, N. (1975). 'Diogenes syndrome'. Lancet. 305 (7905): 515. doi:10.1016/S0140-6736(75)92850-0.
  • Cole, AJ; Gillett, TP.; Fairbairn, Andrew (1992). 'A case of senile self-neglect in a married couple: 'Diogenes a deux''. Int J Geriatr Psychiatry. 7 (11): 839–41. doi:10.1002/gps.930071111.
  • O'Mahony, D; Evans, JG (1994). 'Diogenes syndrome by proxy'. The British Journal of Psychiatry. 164 (5): 705–6. doi:10.1192/bjp.164.5.705. PMID7921736.
  • Post F. 'Functional disorders: 1. Description, incidence and recognition'. In: Levy R, Post F, eds. The psychiatry of late life. Oxford: Blackwell, 1982;180-1.
  • Roe, PF. (1977). 'Self-neglect'. Age Ageing. 6 (3): 192–4. doi:10.1093/ageing/6.3.192. PMID899969.
  • MacAnespie, H (1975). 'Diogenes Syndrome'. The Lancet. 305 (7909): 750. doi:10.1016/S0140-6736(75)91664-5. PMID47514.
  • Wolfson, P; Cohen, M; Lindesay, J; Murphy, E (1990). 'Section 47 and its use with mentally disordered people'. Journal of Public Health Medicine. 12 (1): 9–14. doi:10.1093/oxfordjournals.pubmed.a042517. PMID2390316.

External links[edit]

Diogenes

  • 'Husband let wife starve to death' – BBC News item, Friday, 28 March 2008
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