She had no insight, and refused any form of treatment.
She was very agitated, and was verbally and physically abusive to staff. She was disheveled, unkempt, wearing dirty clothes, and was foul smelling. She was found to have pressured speech, elated mood, increased energy, and very poor personal hygiene. Keeping this constellation of symptoms in mind will allow for a more prompt diagnosis and initiation of management of these clients.Ī 61-year-old obese Caucasian female with a previous history of bipolar 1 disorder and hypothyroidism, presented for an out-patient psychiatric follow-up review accompanied by her Community Psychiatry Nurse. This paper identifies that these patients can present due to a variety of reasons, and sometimes only by chance. This can make specific causes of death difficult to determine. These individuals self-isolate, and therefore may not be found until much later post-mortem. This is subsequent to self-neglect, poor infection control practices, nutritional deficiency, and lack of presentation to medical care. Mortality is increased in these patients, with a 46% five-year death rate, which is commonly due to physical illnesses such as pneumonia. Syllogomania is differentiated from Diogenes in that other characteristics such as the squalor and neglect are present in DS.
Diogenes syndrome vs hoarding manual#
There are suggestions that an orbitofrontal brain lesion may lead to such behaviours, while others state that chronic mania symptoms, such as poor insight, can lead to such a condition.Īlthough DS is not uniquely recognized in the Diagnostic and Statistical Manual (DSM) of Mental Disorders, the fifth version of the manual now identifies hoarding (syllogomania), as a psychiatric diagnosis. While no clear etiology exists, it is hypothesized that it may be due to a stress reaction in people with certain pre-morbid personality traits, such as being aloof, or certain personality disorders, such as schizotypal or obsessive compulsive personality disorder. It is often associated with other mental illnesses, such as schizophrenia, mania, and frontotemporal dementia. Affected individuals come from any socioeconomic status, but are usually of average or above-average intelligence. The approximate annual incidence of Diogenes is 0.05% in people over the age of 60. Diogenes syndrome (DS) is a behavioural disorder characterized by domestic filth, or squalor, extreme self-neglect, hoarding, and lack of shame regarding one’s living condition.
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