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Diogenes syndrome — an Irish series

Published online by Cambridge University Press:  13 June 2014

Margo Wrigley
Affiliation:
Department of Old Age Psychiatry, James Connolly Memorial Hospital, Blanchardstown, Dublin 15
Colm Cooney
Affiliation:
Department of Old Age Psychiatry, James Connolly Memorial Hospital, Blanchardstown, Dublin 15

Abstract

Objective: Diogenes syndrome or the senile squalor syndrome is characterised by gross self neglect, domestic squalor and social withdrawal. Two series of such patients have been described in Britain. This paper examines the frequency and characteristics of the syndrome in an Irish urban population and discusses the management issues involved. Method: Detailed demographic, social, medical and psychiatric data was collected on all patients fulfilling the criteria for Diogenes syndrome who were referred to the North Dublin Old Age Psychiatry Service over a two year period 1989-1990. Results: Twenty nine cases (5% of all referrals) were identified giving an incidence rate of 0.5% per annum. Most were single or widowed (83%), and living alone (72%). 79% were known to the public health nurse and 59% had at least one medical problem. The commonest reason for referral was self-neglect. Thirteen suffered from senile dementia, three had schizophrenia, three were alcohol dependent and 10 had no psychiatric diagnosis. Subsequently, 12 patients remained at home, 12 moved into residential care and five died. Conclusion: The patients in this Irish series resemble those in the two British series. Management issues emphasised are the need to consider each patient as an individual and to balance risk with the right to self-determination. The role of care teams for the elderly in overall management is discussed.

Type
Original Papers
Copyright
Copyright © Cambridge University Press 1992

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References

1.MacMillan, D, Shaw, P. Senile breakdown in standards of personal and environmental cleanliness. BMJ 1966; ii: 10321037.CrossRefGoogle Scholar
2.Clark, AN, Mankikar, GD, Gray, I. Diogenes syndrome. Lancet 1975; i: 366368.CrossRefGoogle Scholar
3.Cybulska, E. Gross self-neglect in old age. Br J Hosp Med 1986; 7: 2124.Google Scholar
4.Post, F. In Levy, R, Post, F, editors. The psychiatry of late life. Oxford: Blackwell Scientific Publications, 1982: 180181.Google Scholar
5.Wrigley, M, Gannon, M. The North Dublin old age psychiatry service. Ir J Psychol Med 1990; 7: 135137.CrossRefGoogle Scholar
6.Folstein, ME, Folstein, SE. Mini-Mental State. A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 1975; 12: 189–95.CrossRefGoogle Scholar
7.Pattie, AH. A survey version of the Clifton Assessment Procedures for the Elderly (CAPE). Br J Clin Psychol 1981; 20: 173178.CrossRefGoogle ScholarPubMed
8.Henderson Smith, SL. Diogenes syndrome [letter]. Lancet 1975; i: 515.Google Scholar
9.MacAnespie, H. Diogenes syndrome [letter]. Lancet. 1975; i: 750.CrossRefGoogle Scholar
10.Twomey, J. Diogenes syndrome [letter]. Lancet 1975; i: 515.Google Scholar
11.Mental Treatment Act (1945). Dublin: Stationary Office.Google Scholar
12.National Assistance Act (1948). London: H.M.S.O.Google Scholar
13.Muir Gray, JA. Section 47. Age and ageing 1980; 9: 205209.Google Scholar
14.Norman, AJ. Rights and risk: a discussion document on civil liberty in old age. London: Centre for Policy on Ageing, 1980.Google Scholar
15.The years ahead – a policy for the elderly. Dublin: Stationary Office, 1988.Google Scholar
16.Eastern Health Board. Services for the elderly – a policy document. Dublin: St. Mary's Hospital, 1989.Google Scholar