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Diogenes Syndrome

Senile Squalor Syndrome


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]
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]
Gangrene
  • Severe squalor can result in skin infections, wounds, and gangrene, which need to be addressed. In case of patients affected by mental health disorders, psychotherapy or behavioral treatment might be required.[psychologenie.com]
  • I could not see beyond the dirt on his feet to tell if he has gangrene. He will need a mental health assessment for the possibility of Diogenes Syndrome.” Pretty nasty, then. Very alarming. Something certainly had to be done.[themaskedamhp.blogspot.com]
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]
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]
Intravenous Administration
  • For instance, in severe cases where the patient is severely dehydrated and malnourished, intravenous administration of fluids and certain drugs is required.[psychologenie.com]
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]
Poor Oral Hygiene
  • There was poor oral hygiene and halitosis.A 6 8cm solitary, firm, non-tender, mobile mass was present in her right breast [Figure 2]. The overlying skin was stretched with engorged veins.[e-ijd.org]
  • 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]
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]
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]
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]
Hyperkeratosis
  • Figure 3: (a) Hyperkeratosis with yeasts in stratum corneum (H and E 40).[e-ijd.org]
Cutaneous Manifestation
  • Mental illness, withdrawal and denial of need in old age may be triggered by various stressful situations. [2] The cutaneous manifestations of neglect (dermatitis passivata) arise from accretion of keratin and dirt and resemble a carapace.[e-ijd.org]
Paranoid Ideation
  • She also exhibited paranoid ideations toward the staff. She was started on risperidone 0.5 mg orally twice per day; however, she refused to take any medications. After three weeks of hospitalization, she was discharged from the hospital. Ms.[consultant360.com]
Poor Coordination
  • ., extreme drowsiness, incoherent speech, poor coordination and equilibrium, nausea and vomiting), companions should call 911 immediately to request emergency medical attention.[altamirarecovery.com]
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]
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]

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]
  • 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]
  • 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]
  • […] 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]
  • The syndrome is etiologically complex, and psychiatric and/or neurological comorbidities may be present, but not necessarily so.[ncbi.nlm.nih.gov]
  • The patient reported in the present paper did not meet criteria for such comorbidities. 14 Regarding the etiology of the syndrome, the following hypotheses are proposed: • representation of the “final stage” of a personality disorder; • manifestation[ggaging.com]

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]
Sex distribution
Age distribution

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]
  • […] 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]
  • 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]
  • 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]
  • 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]

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