![]() Certain 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. Alcohol abuse has been identified as a cofactor. Secondary DS is related to mental illness like schizophrenia, depression, and dementia. DS has been classified as primary or pure which is not associated with mental illness and secondary or symptomatic. The disorder 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. This usually affects elderly persons and there is no sex predilection. The term Diogenes syndrome was coined in 1975 by “Clark et al.”. With regular washing and treatment with antibiotics and antipsychotics improvement was satisfactory.ĭiogenes syndrome is also known as dermatitis passivata. We also did Gram staining, bacterial and mycological culture from the discharge of the lesion, which did not reveal growth of any organism. His blood VDRL in titre were nonreactive. Routine blood investigation and X-ray chest was noncontributory. Inflammatory cells were mostly found at perivascular and periappendageal regions and consisted of plenty of neutrophils with few lymphocytes and macrophages (Figures (Figures3 3 and and4). Skin biopsy was taken from a lesion and under light microscopy it showed hyperkeratosis with mainly upper dermal infiltrate. We sent the patient to the psychiatry OPD and there he was diagnosed as a case of schizophrenia. He was a graduate and working as a computer programmer. Patient was alert and cooperative but was severely depressed and had been stubbornly refusing help from neighbours. There was no suggestive feature of scabies or pediculosis clinically. His scalp, groin, and face were almost spared. Few lesions were acneiform and there were multiple furuncles ( Figure 2). On examination multiple nodular lesions with crusting on an erythematous base were present mainly over the trunk and upper extremities ( Figure 1). His home was filthy and was crowded with furniture, old books, and scraps of papers in huge heaps. They also reported that the man had not taken a bath for longer than 2 years. According to the persons who coaxed him to come to the OPD, the patient lived alone with least interaction with his neighbours and had no relatives to visit him. Lack of standardized instruments to measure squalor have prevented researchers from understanding squalor in compulsive hoarding”.A 34-year-old male patient was brought to our OPD by his neighbours with multiple discrete papulonodular lesions mainly over the trunk with heaped up crusting, for the last 6 months. Many subjects could not use their refrigerator (45%), kitchen sink (42%), bathtub (42%), or toilet (10%). For 32% of the residences, there was an overpowering odor from rotten food or animal or human feces. In their sample, 17% of individuals were described as ‘extremely filthy’ and 33% of residences were rated as ‘extremely filthy and dirty’. focused on cleanliness ratings of the personal appearance and the homes of 62 elderly hoarding individuals. surveyed health department officers in Massachusetts who reported that 38% of their hoarding cases were ‘heavily cluttered with filthy environment, overwhelming’. A few studies have provided more direct indications of squalor in hoarding. (1999) noted that clutter inhibited normal activities of daily living – including personal hygiene. “Research on hoarding has rarely included assessments of severe domestic squalor. ![]() ![]() ![]() There are suggestions that an orbitofrontal brain lesion may lead to such behaviours…while others state that chronic mania symptoms, such as poor insight, can lead to such a condition”. Affected individuals come from any socioeconomic status, but are usually of average or above-average intelligence…It is often associated with other mental illnesses, such as schizophrenia, mania, and frontotemporal dementia…While no clear etiology exists, it is hypothesized that it may be due to a stress reaction in people with certain pre-morbid personality traits, such as being aloof, or certain personality disorders, such as schizotypal or obsessive compulsive personality disorder. ![]() 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’…The approximate annual incidence of Diogenes is 0.05% in people over the age of 60. He kept his need for clothing and food to a minimum by begging. “DS is named after the Greek Philosopher “Diogenes of Sinope” (4th century BC) who taught about cynicism philosophy. ![]()
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