Most patients showing self-neglect are diagnosed with dementia within 1 or 2 years of presentation 16. New-onset Diogenes syndrome in older age may be due to dementia, for instance. Therefore, these cases can be classified as secondary Diogenes Syndrome 14. At least in 50% of the cases a kind of psychiatric disorder was described 15. However, differences among the cases in cognitive and socio-economic levels were reported 14. In some studies, it was reported that there were no mental illness in patients affected by Diogenes syndrome on the contrary they have average or high intellectual level 13. However, it was indicated that an exaggerated sense of self disorganized lifestyle or indifference depending on the aggravation can occur together with older ages 12. These patients may have psychiatric disorders like paranoid disorders, mood affection, or temporofrontal dementia 1. Diogenes syndrome causesĪlthough exact causes of Diogenes syndrome is not still well known, it has been hypothesized that Diogenes syndrome may occur as a result of a response given to the various stress factors such as death of spouse or a significant medical illness among people with subclinical personality disorder 11. Dirt, dust, bacterial, fungal, and parasitic debris conglomerate to form thick crusts and scales over various parts of the body 8.
DIOGENES SYNDROME CAUSES SKIN
Skin lesions are mainly due to uncleanliness which may result in various infestations and infections. Multiple deficiency states have been associated with Diogenes syndrome including iron, folate, vitamin B12, vitamin C, calcium and vitamin D, serum proteins and albumin, water, and potassium 4. Such persons usually have above average intelligence and it is now clear that some stressful event precipitates the disease in predisposed individuals. Though principally affecting the elderly, young persons have been diagnosed with this condition. A question has been raised whether Diogenes syndrome is due to self-neglect or maltreatment of the elderly but the latter has been identified as the most probable cause resulting in this pitiful condition 5. At least 4 of them are almost permanent symptoms: patients do not ask for any help although they possesses nothing unusually fond of objects (hoarding of rubbish, or nothing in the house) unusual behavior with other people (misanthropy) and extreme self-neglect 9. Secondary Diogenes syndrome is associated with underlying mental illness like schizophrenia, depression, and dementia 5. Alcohol abuse has been identified as a cofactor 8.Ĭertain characteristics of the Diogenes syndrome have been recognized these include social withdrawal, filthy home, neglected self care, squalor syndrome, collection of useless objects or hoarding, shameless attitude, and stubborn refusal of help 5. Mental illness, withdrawal and denial of need in old age may be triggered by various stressful situations 7.ĭiogenes syndrome has been classified as primary or pure which is not associated with mental illness and secondary or symptomatic. Nutritional deficiencies of iron, folate, vitamin B12, vitamin C, vitamin D and serum proteins may be seen. Hoarding of rubbish may or may not be present 6. Diogenes syndrome usually follows a distinct sociodemographic profile where it is found that persons are usually single, aged, having average or above average intelligence, and also having good income 5. Most live alone in physical isolation 2. Diogenes syndrome usually affects elderly persons and there is no sex predilection. Diogenes syndrome affects men and women equally and may be seen in all socioeconomic groups. 4 to describe elderly patients with severe self-neglect, poor personal and domestic hygiene. The term Diogenes syndrome was coined in 1975 by Clark et al. Diogenes syndrome has been described in different psychiatric literature and very few cases associated with dermatological presentation have been reported. He used to follow some ideas like “life according to nature,” “self-sufficiency,” “freedom from emotion,” “lack of shame,” “outspokenness,” and “contempt for social organization” 3. He kept his need for clothing and food to a minimum by begging. Diogenes syndrome is named after the Greek Philosopher “Diogenes of Sinope” (4th century BCE) who taught about cynicism philosophy (minimizing needs and a natural way of life) 3. Diogenes syndrome is a rarely reported syndrome of extreme self-neglect, social withdrawal and domestic squalor 2. Diogenes syndrome treatment Diogenes syndromeĭiogenes syndrome also known as dermatitis passivata, severe self-neglect syndrome, aged recluse or social breakdown of the elderly, is characterized by extreme self-neglect, poor personal and domestic hygiene and social withdrawal with abnormal collecting pattern, tendency to hoard excessively (syllogomania), and refusal of help, which may be precipitated by stressful event 1.
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