The Diogenes syndrome: a case report

Abstract

Introduction: The Diogenes syndrome is a behavior disorder of the elderly characterized by the rejection of social patterns, poor personal hygiene, progressive social isolation, and impaired judgment, associated with the accumulation of objects and trash. Research on this syndrome is scarce but one third to one half of affected individuals show no concomitant psychiatric disorders. Clinical case: We present the case of a 78 year-old single female with a fourth grade education, living alone since her sister’s death, three years previously. No relevant medical or surgical history was obtained. She was brought for the first time to a consultation by a neighbour, who stated that the patient was living in a house with poor hygienic conditions. The neighbour provided care once a week. A home visit was arranged to assess her living conditions. An accumulation of objects and waste was found in the patient’s home. Evaluation by a social worker was requested but the patient refused her entry into her home. A court order was obtained for psychiatric assessment. Comment: With the aging of the population there is a growing need for care of the elderly. This is clear when a decrease in the functional capacity of the elderly prevents self-care. This increases the responsibility of the family and the health care system. Severe isolation associated with Diogenes syndrome and a life on the margins of society, make detection difficult in these situations. Home visits play a key role in the early detection of this condition. The family physician, as first-line care provider, should promote the integration of family and other caregivers in the care of these patients.