Presentation
Patients may present due to a range of reasons. Recognizing these will allow for earlier management of this high-mortality condition.Case presentation61-year Caucasian female known with bipolar 1 disorder presented with manic symptoms. [semanticscholar.org]
Brian Misiaszek, McMaster University Presenter(s): Dr. [brainxchange.ca]
We report a case of Diogenes syndrome presenting with dermatitis passivata. [e-ijd.org]
Results and Conclusions: We describe the clinical case of a 90-year-old man which presented with a 5-year history of progressive behavioral changes. [morressier.com]
The authors found that ill individuals presented normal intelligence or above the average. In 50% of the cases, no psychiatric disorder was found. 13 The patient was a theologian, polyglot and did not present evidence of other psychiatric disorders. [ggaging.com]
Entire Body System
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Pain
While this is sometimes the case, such as in chronic pain sufferers or those developing Alzheimer's, it is not true for everyone and that person may just need to help to recognize what’s going on. [medium.com]
Patterns of excessive hoarding and self-neglect in the elderly can be painful to witness, and even harder to remedy when you’re dealing with a stubborn person. [shieldmysenior.com]
Withdrawal and Detox Any time a person is attempting to overcome a drug or alcohol problem, they will have to pass through a withdrawal stage before their sobriety can begin to truly take hold—and withdrawal can be painful, highly stressful, and even [altamirarecovery.com]
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Noncompliance
Noncompliance with treatment and follow-up are almost universal. Physical illness, such as pneumonia and multiple nutritional deficiency states, is common, and the mortality rate can be high. [consultant360.com]
[…] described the significant improvements seen in FTD patients with DS after the start of treatment with quetiapine and sodium valproate. 53 The use of selective serotonin reuptake inhibitors to manage the compulsive hoarding behaviors has been reported. 54 Noncompliance [ncbi.nlm.nih.gov]
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Anemia
[…] low hemoglobin level (8.9 g/dL [12-16 g/dL]), low hematocrit level (26.4% [37-47%]), low serum iron level (16 g/dL [35-175 g/dL]), and upper-normal iron-binding capacity (389 g/dL [250-400 g/dL]), suggesting that the patient had iron deficiency anemia [consultant360.com]
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Painter
A depiction of Diogenes, by French painter Jean-Leon Gerome ( 1 ), is shown in Figure 1. Macmillan and Shaw first described the syndrome in 1966 ( 2 ). The term Diogenes syndrome was later coined by Clark et al. in 1975 ( 3 ). [psychiatryonline.org]
Respiratoric
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Aspiration
We have seen plenty of empty promises and aspirations to achieve targets without any sense of reality and insight. A person with Diogenes syndrome exhibits unpredictable mood swings, aggressive and stubborn behaviour. [bgs.org.uk]
Jaw & Teeth
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Halitosis
Another complication that doctors have found is poor oral hygiene, which can lead to dental decay and halitosis. Hoarding and Diogenes syndrome Researchers have described Diogenes syndrome as "a special manifestation of hoarding disorder." [medicalnewstoday.com]
Cardiovascular
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Hypertension
F” is a 78-year-old widowed, Caucasian man with a past medical history of hypertension and coronary artery disease who was diagnosed with carcinoma of the paranasal sinus with leptomingeal carcinomatosis 6 weeks prior. [psychiatryonline.org]
Skin
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Papule
Dark brown dirt like papules were found on neck, lower back, intermammary and inframammary area. There was poor oral hygiene and halitosis.A 6 8cm solitary, firm, non-tender, mobile mass was present in her right breast [Figure 2]. [e-ijd.org]
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Hyperkeratosis
Figure 3: (a) Hyperkeratosis with yeasts in stratum corneum (H and E 40). [e-ijd.org]
Psychiatrical
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Mood Swings
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 [youtube.com]
A person with Diogenes syndrome exhibits unpredictable mood swings, aggressive and stubborn behaviour. [bgs.org.uk]
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 [en.wikipedia.org]
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Grieving
In times of distress and grieving, everyday activities like personal care tend can become disrupted, or a person may overlook them. [medicalnewstoday.com]
Neurologic
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Stroke
Other risk factors include brain damage (particularly in the frontal lobe), a history of mental illness, physical impairments with loss of mobility, stroke, congestive heart failure, and substance abuse. [countyhealthcareguide.com]
A health episode such as a stroke or dementia. Loneliness. [parentsarehardtoraise.org]
In the end, the Board concluded that the evidence of mild dementia, slight memory loss, Diogenes syndrome, and brain damage from small strokes indicated that she lacked capacity to manage her property. This post is part 1 of 2. [cnpea.ca]
These can include: stroke loss of mobility due to arthritis or broken bones congestive heart failure dementia vision problems increasing frailty depression Other risk factors include: loss of a trusted companion or caregiver history of mental illness [healthline.com]
They also may be at risk for associated conditions like stroke or have had an attack in the past. The frontal lobe is in control of our attention span, judgment, decisions, and capability of making plans. [medium.com]
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Agitation
Resistance gets stronger for senile persons with dementia, who may become confused and more agitated. Sneaky techniques are ethically questionable, and so are not attempted. [shieldmysenior.com]
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Forgetful
Forget about the 5 rooms that need to be done and start sorting through the first room. Huge tasks of outrageous proportions, broken up into small segments, seem more attainable. [aplaceformom.com]
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Mild Cognitive Impairment
A doctor at the hospital said the patient had Diogenes syndrome, delusional disorder, mild cognitive impairment and paranoid personality disorder Her house was described as filthy with cat feces and urine. [cnpea.ca]
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Cognitive Disorder
disorders. 16, 17 The age range in the Clark et al study is of 66 to 92 years (average, 79 years), 3 although younger individuals have been described: 30.9% of cases in a selected sample was below 65 years of age. 18 According to Shah and Reyes-Ortiz [ncbi.nlm.nih.gov]
Treatment
Treatment and Prognosis for Addiction and Diogenes Syndrome There are special factors involved when providing mental health and drug and alcohol treatment for elderly patients. [altamirarecovery.com]
Their doctor will decide how to work with the individual and their family to help come up with a treatment plan. It’s possible to recover from Diogenes syndrome. The help and support of others is an important part of a treatment plan. [healthline.com]
There's a lack of information on the pharmacological treatment. More often than not, a multidimensional approach is followed for the treatment. [psychologenie.com]
There is no specific surefire treatment for Diogenes Syndrome. However, if you know someone who has it, you should get them into an adult care facility as soon as possible. [goldenplacements.com]
The initial treatment should be a behavioral program, but there is not sufficient information regarding pharmacological treatment of the syndrome. [ncbi.nlm.nih.gov]
Prognosis
The prognosis is also poor, with 46% of the patients having a 5-year mortality rate, possibly due to physical complications. 14 OUTCOME OF THE CASE PATIENT Unfortunately, Ms. G refused follow-up care and had no further contact with the hospital. [consultant360.com]
Diogenes Syndrome Prognosis and Treatment Options There are a few tactics for treating senior hoarding and squalor. The most effective tactic is to remove the senior from the conditions of squalor and place them into a supervised living facility. [shieldmysenior.com]
Treatment and Prognosis for Addiction and Diogenes Syndrome There are special factors involved when providing mental health and drug and alcohol treatment for elderly patients. [altamirarecovery.com]
[…] alteration of executive functions can explain the simplification of complex tasks, such as maintenance of washing. 45 A possible link with frontal lobe dementia has been questioned due to the younger age of onset of this type of dementing disease. 21, 46 The prognosis [ncbi.nlm.nih.gov]
Etiology
The plausible psychological etiologies are discussed in the context of existential values in Chinese culture and changes in traditional family dynamics as the society modernizes. [dovepress.com]
The main etiological hypotheses are: (1) the condition represents the "end-stage" of a personality disorder; (2) the syndrome is a manifestation of a frontal-lobe dementia; (3) DS may be an end stage of the hoarding subtype of OCD; (4) DS may be a final [scielo.br]
The objectives of the present study were to look for the most appropriate appellation, the frequency of clinical symptoms, the underlying associated diseases, and to investigate a possible central etiology. [jarcp.com]
[…] squalor have focused on elderly populations recruited from nursing or disability services…These studies initially suggested that those living in squalor were likely to be over the age of 60, primarily female, living alone and unmarried…Hypotheses on the etiology [psychologytoday.com]
The syndrome is etiologically complex, and psychiatric and/or neurological comorbidities may be present, but not necessarily so. [ncbi.nlm.nih.gov]
Epidemiology
[…] predictors of mortality in this population, including comorbidity. 12 Miss Havisham from Dickens' Great Expectations might be a better example of the syndrome, 13 but even more convincing descriptions can be found in Nikolaj Gogol's novel, Dead Souls. 14 Epidemiology [ncbi.nlm.nih.gov]
Prevention
Efforts should be made to prevent the condition from worsening to such an extent that compulsory action is required due to the risks posed by the hoarding of garbage and domestic squalor. [psychologenie.com]
A concrete approach to home safety, including preventing additional clutter, establishing a cleaning plan, discarding objects, and organizing the living space, have been successful over time in assisting older adults in regaining a sense of control over [consultant360.com]
[…] or physically incapacitated, is living in unsanitary conditions AND the person is unable to devote to himself and is not receiving from other persons proper care and attention AND his removal from home is necessary either in his own interests or for preventing [themaskedamhp.blogspot.com]
Compassion will be in short supply, but try to remember that hoarders suffer from a neurological condition which prevents them from remembering, planning, assessing, and executing actions effectively. They aren’t playing with a full deck. [shieldmysenior.com]
Diogenes syndrome is a condition that prevents sufferers from comprehending reality, and they may put up walls of denial that are difficult to break through because they are unaware of the depth of their problems. [altamirarecovery.com]