Diogenes syndrome

• Social Breakdown Disorder (Macmillan 1966)
• Gross Self Neglect syndrome (Cybulska 1986)
• Senile Squalor Syndrome (Shah 1990 )
• Social Breakdown in the Elderly (Ungvari 1991)
• Syndrome of Extreme Self-Neglect (Refler 1996)
• Litter Hoarding Syndrome (Jurgens 2000)
• Messie-Syndrom (Barocka 2004)

Diogenes syndrome, also known as senile squalor syndrome, is a disorder characterized by extreme self-neglect, domestic squalor, social withdrawal, apathy, compulsive hoarding of rubbish, and lack of shame.

The condition was first recognized in 1966 and designated Diogenes syndrome by Clark et al. The name derives from Diogenes of Sinope, an ancient Greek philosopher, a Cynic and an ultimate minimalist, who allegedly lived in a barrel. Not only did he not hoard, but he actually sought human company by venturing daily to the Agora. Therefore, this eponym is considered to be a misnomer. Other possible terms are senile breakdown, Plyushkin’s Syndrome (after a character from Gogol’s novel Dead Souls), social breakdown and senile squalor syndrome. Frontal lobe impairment may play a part in the causation (Orrell et al., 1989).

• Inability to attend to one’s health, hygiene, nutrition or social needs
• Incidence & prevalence increases with age
• Association with: depression, dementia, mental illness, substance abuse, frailty, vision impairments & elder abuse
• Poor nutrition common
• Generally living on tea, toast, bread, biscuits, tins of food
• ETOH^* (mis)use can be significant

*ETOH, when used in a medical context, is an abbreviation for ethanol (i.e. alcohol). For instance, “ETOH 10g/day” denotes that the patient drinks 10 grams (or roughly one standard drink) of alcohol a day on average.