What is Diogenes Syndrome?
Diogenes Syndrome is a psychologic condition where the patient lacks self-care and even does not take care of the surroundings. It results in the individual having extremely poor hygiene causing health as well as social issues. Generally, Diogenes Syndrome occurs with other mental disorders like dementia. Self-neglect and social isolation is extremely common in people with Diogenes Syndrome. Such individuals also tend to hoard things. These individuals live in unhygienic conditions which is why they tend to have variety of health problems.[1]
However norms for self-hygiene are variable and differ from culture to culture. For example, eating with hands is a norm for people in the Indian Subcontinent but is considered as unhygienic in the western part of the world. This is the reason why the symptoms of Diogenes Syndrome are difficult to assess. However, some of the habits of people with this condition clearly point towards self-neglect like not interested in taking a bath or cleaning the house is a clear evidence of self-neglect.[1]
As stated, Diogenes Syndrome normally occurs in relation with other psychiatric conditions and there is very little in terms of data available in the literature the DSM IV criterion for diagnosis does not list Diogenes Syndrome as a separate psychiatric condition. However, there are cases where there are no underlying medical or psychiatric conditions but an individual still displays certain symptoms of Diogenes Syndrome. This is termed as Primary Diogenes Syndrome.[1]
If Diogenes Syndrome occurs as a result of other mental disorders then it is termed as Secondary Diogenes Syndrome. This condition is also known by several other names like self-neglect syndrome and social breakdown syndrome.[1] What causes Diogenes Syndrome and ways to deal with it is what has been discussed in the article below.
What Causes Diogenes Syndrome?
As stated, there is very little data in terms of research for Diogenes Syndrome. Experts are still studying this condition to understand the exact causes of it. Whatever data that is available about Diogenes Syndrome is through case studies. Majority of the case studies are of a single person rather than a group of different cases. This is a major drawback of the research as symptoms vary from individual to individual and just single case studies do not shed much light on the cause of Diogenes Syndrome.[1]
Most of the experts believe that approximately 50% of the cases of Diogenes Syndrome occur without any prior history of any mental condition. Researchers opine that in such instances the condition develops as a result of excessive stress due to some traumatic event like losing a loved one in the recent past. The reason behind this is that when an individual loses someone very close to them, the distress and grief causes major disruption in daily life including personal hygiene and most of the time people tend to overlook. This lack of self-care and social isolation makes Diogenes Syndrome different from hoarding which has similar clinical features with this condition.[1]
Since there is not much data available, the affect that Diogenes Syndrome has on the overall health and social situation of the patient is not clearly understood. What is known in the data though is that people with Diogenes Syndrome tend to have a short lifespan due to the symptoms.[1]
What are the Symptoms of Diogenes Syndrome?
The symptoms of Diogenes Syndrome are variable and differ from patient to patient but the most common symptoms include self-neglect where the patient does not take care of personal hygiene and that of the environment in which the patient stays. People with Diogenes Syndrome also have poor insight of public health and safety and do not trust people they come across.[1]
It has also been seen that Diogenes Syndrome patients are paranoid and treat every person they meet with suspiciousness. They mostly lead a lonely life without much interaction with others and are literally detached from the society. Whenever they come across a social situation they become extremely anxious.[1]
People with Diogenes Syndrome also tend to have features of obsessive compulsive disorder. They hoard household articles and waste products to an extent that they live in extremely unhygienic, unsanitary, and hazardous living conditions. They tend to have a very poor diet and seldom eat nutritious food. They are completely unwilling to take any help from anyone due to lack of trust on anyone. Even if somebody tries to help them they may become extremely aggressive and hostile.[1]
The self-neglect of patients with Diogenes Syndrome reaches to such an extent that they start to have dermatological conditions like dermatitis. This is usually caused due to lack of proper personal hygiene lack bathing regularly. These patients also have a very poor oral and dental hygiene due to lack of cleaning and poor self-care. The hoarding that people with Diogenes Syndrome do can be a public hazard, as it attracts plenty of insects which is not health for both the patient as well as people living nearby.[1]
How is Diogenes Syndrome Treated?
There is no formal treatment for Diogenes Syndrome. Experts suggest conducting a complete physical examination, taking history, and doing organ tests is the priority. This will give the physicians an idea about the basic health status of the patient. Other conditions causing similar symptoms should also be ruled out by conducting scans and other radiographic studies. A detailed personality assessment is done to try and identify a cause for the condition.[1]
As of now, there are no specific medications to manage Diogenes Syndrome. However, some of the symptoms like paranoia can be managed with counseling and medications. Aggressive psychological counseling is a must for people with Diogenes Syndrome as there are many psychological factors that worsen the condition. It is quite hard to convince a patient with Diogenes Syndrome to go for treatment due to lack of trust of the patient on medical institution and society at large. However, if proper support system is present then it becomes easier to manage symptoms of Diogenes Syndrome.[1]
Taking help of cleaning and personal care service providers are also helpful in decreasing the severity of the symptoms even though the patient will be reluctant to take any help from outside but they have to be convinced. This is the reason why healthcare workers need to handle every patient with Diogenes Syndrome with extreme caution and sensitivity. [1]
It should be noted however that if at any time the patient feels that the healthcare workers are not trustworthy or are being judgmental then the situation may worsen and the patient may not cooperate for treatment of the symptoms of Diogenes Syndrome and may go back to prior habits and behaviors.[1]
