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A preliminary investigation of domestic squalor in people with a history of alcohol misuse: neuropsychological profile and hoarding behavior – an opportunistic observational study

Published online by Cambridge University Press:  16 June 2015

Andrew Gleason ,
Matthew Lewis ,
Sook Meng Lee  and
Stephen Macfarlane
Andrew Gleason
Affiliation:
Aged Psychiatry Service, Caulfield Hospital, Alfred Health, Victoria, Australia Department of Psychiatry, University of Melbourne, Victoria, Australia
Matthew Lewis
Affiliation:
Aged Psychiatry Service, Caulfield Hospital, Alfred Health, Victoria, Australia
Sook Meng Lee
Affiliation:
Aged Psychiatry Service, Caulfield Hospital, Alfred Health, Victoria, Australia Department of Geriatric Medicine, Western Health, Sunshine, Victoria, Australia
Stephen Macfarlane*
Affiliation:
Aged Psychiatry Service, Caulfield Hospital, Alfred Health, Victoria, Australia
*
Correspondence should be addressed to: Stephen Macfarlane, Associate Professor, Aged Psychiatry Service, Caulfield Hospital, 260 Kooyong Road, Caulfield 3162, Victoria, Australia. Phone: +613-9076-6600; Fax: +613-9076-6180. Email: [email protected].
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Abstract

Background:

Domestic squalor has been associated with alcohol misuse but little work has explored this. Executive dysfunction is commonly observed in squalor and is also associated with alcohol misuse. Hoarding can accompany squalor, but it is unclear whether hoarding is also linked with alcohol misuse. This study compared neuropsychology and hoarding status of individuals living in squalor with and without a history of alcohol misuse.

Methods:

A subgroup analysis was conducted on a series of 69 neuropsychological reports of people living in squalor. Data on cognitive profiles, basic demographics, alcohol use, and hoarding were extracted and analyzed.

Results:

Alcohol misuse was reported in 25 of the 69 participants (36%). Alcohol misusers were significantly younger (mean age 66.2 years, SD = 10.7) than non-misusers (mean age 75.6 years, SD = 10.3) (p < 0.00) and significantly more likely to be male (p = 0.01). No significant differences between the two subgroups were found for estimated premorbid intellectual functioning, Mini Mental State Examination (MMSE) scores, or individual neuropsychological domains. Alcohol misusers were more likely to be living in squalor without hoarding than squalor with hoarding (p = 0.01).

Conclusions:

Alcohol misusers living in squalor were less likely to hoard than non-misusers. This finding suggests that alcohol misuse may be a risk factor for squalor via failure to maintain one's environment rather than through intentional accumulation of objects. The similar cognitive profile among those with and without a history of alcohol misuse could represent a common pattern of executive dysfunction that predisposes individuals to squalor regardless of underlying alcohol misuse diagnosis.

Keywords

squalorhoardingalcoholneuropsychologyfrontalexecutive function
Type
Research Article
Information
International Psychogeriatrics , Volume 27 , Issue 11 , November 2015 , pp. 1913 - 1918
Copyright
Copyright © International Psychogeriatric Association 2015 

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References

American Psychiatric Association (2013). Diagnostic and Statistical Manual of Mental Disorders: DSM-5. Arlington: American Psychiatric Publishing.Google Scholar
Ayers, C. R., Wetherell, J. L., Schiehser, D., Almklov, E., Golshan, S. and Saxena, S. (2013). Executive functioning in older adults with hoarding disorder. International Journal of Geriatric Psychiatry, 28, 1175–1181.Google Scholar
Chan, S. M., Leung, P. Y. and Chiu, F. K. (2007). Late-onset diogenes syndrome in Chinese – an elderly case series in Hong Kong. Neuropsychiatric Disease and Treatment, 3, 589–596.Google ScholarPubMed
Clark, A. N., Mankikar, G. D. and Gray, I. (1975). Diogenes syndrome: a clinical study of gross neglect in old age. Lancet, 15, 366–368.CrossRefGoogle Scholar
Crews, F. T. et al. (2005). Alcoholic neurobiology: changes in dependence and recovery. Alcoholism: Clinical and Experimental Research, 29, 1504–1513.CrossRefGoogle ScholarPubMed
Folstein, M. F., Folstein, S. E. and McHugh, P. R. (1975). “Mini-Mental State.” A practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12, 189–198.Google Scholar
Gregory, C., Halliday, G., Hodges, J. and Snowdon, J. (2011). Living in squalor: neuropsychological function, emotional processing and squalor perception in patients found living in squalor. International Psychogeriatrics, 23, 724–731.CrossRefGoogle ScholarPubMed
Grisham, J. R. and Norberg, M. M. (2010). Compulsive hoarding: current controversies and new directions. Dialogues in Clinical Neuroscience, 12, 233–240.CrossRefGoogle ScholarPubMed
Halliday, G. and Snowdon, J. (2009). The environmental cleanliness and clutter scale (ECCS). International Psychogeriatrics, 21, 1041–1050.Google Scholar
Halliday, G., Banerjee, S., Philpot, M. and Macdonald, A. (2000). Community study of people who live in squalor. Lancet, 355, 882–886.CrossRefGoogle ScholarPubMed
Jurado, M. B. and Rosselli, M. (2007). The elusive nature of executive functions: a review of our current understanding. Neuropsychology Review, 17, 213–233.CrossRefGoogle ScholarPubMed
Lebert, F. (2005). Diogene syndrome, a clinical presentation of fronto-temporal dementia or not? International Journal of Geriatric Psychiatry, 20, 1203–1204.Google Scholar
Lee, S. M., Lewis, M., Leighton, D., Harris, B., Long, B. and Macfarlane, S. (2014). Neuropsychological characteristics of people living in squalor. International Psychogeriatrics, 26, 837–844.CrossRefGoogle ScholarPubMed
Lezak, M. D., Howieson, D. B. and Loring, D. W. (2004) Neuropsychological Assessment. Oxford: Oxford University Press.Google Scholar
Macmillan, D., Shaw, P. (1966). Senile breakdown in standards of personal and environmental cleanliness. British Medical Journal, 2, 1032–1037.CrossRefGoogle ScholarPubMed
Maier, T. (2004). On phenomenology and classification of hoarding: a review. Acta Psychiatrica Scandinavica, 110, 323–337.CrossRefGoogle ScholarPubMed
Moselhy, H. F., Georgiou, G. and Kahn, A. (2001). Frontal lobe changes in alcoholism: a review of the literature. Alcohol Alcoholism, 36, 357–368.CrossRefGoogle ScholarPubMed
Orrell, M. W. and Sahakian, B. J. (1991). Dementia of frontal lobe type. Psychological Medicine, 21, 553–556.Google Scholar
Orrell, M. W., Sahakian, B. J. and Bergmann, K. (1989). Self-neglect and frontal lobe dysfunction. British Journal of Psychiatry, 155, 101–105.Google Scholar
Ridley, N. J., Draper, B. and Withall, A. (2013). Alcohol-related dementia: an update of the evidence. Alzheimer's Research & Therapy, 5, 3.Google Scholar
Snowdon, J. (1987). Uncleanliness among persons seen by community health workers. Hospital and Community Psychiatry, 38, 491–494.Google Scholar
Snowdon, J. and Halliday, G. (2011). A study of severe domestic squalor: 173 cases referred to an old age psychiatry service. International Psychogeriatrics, 23, 308–314.Google Scholar
Snowdon, J., Halliday, G. and Banerjee, S. (2012). Definition and description of severe domestic squalor. In Snowdon, J., Halliday, G. and Banerjee, S. (eds.), Severe Domestic Squalor (pp. 1–15). Cambridge: Cambridge University Press.CrossRefGoogle Scholar
Snowdon, J., Shah, A. and Halliday, G. (2007). Severe domestic squalor: a review. International Psychogeriatrics, 19, 37–51.Google Scholar
Wrigley, M. and Cooney, C. (1992). Diogenes syndrome – an Irish series. Irish Journal of Psychological Medicine, 9, 37–41.Google Scholar