scholarly journals Diogenes Syndrome: Identification and Distinction from Hoarding Disorder

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Carmel Proctor ◽  
Sakib Rahman
Keyword(s):  
Police Officers ◽  
Social Withdrawal ◽  
Living Condition ◽  
Psychiatric Ward ◽  
Obsessive Compulsive ◽  
Related Condition ◽  
Hoarding Disorder ◽  
Compulsive Disorder ◽  
Somatic Disorders ◽  
Diogenes Syndrome

“Severe domestic squalor” or Diogenes syndrome is characterised by extreme self-neglect of environment, health, and hygiene, excessive hoarding, squalor, social withdrawal, and a distinct lack of concern or shame regarding one’s living condition. This report presents a case of a 51-year-old male admitted to the hospital psychiatric ward following the police removing him from his home. Police officers attended the man’s home following the alarm being raised by his stepfather that he had not been seen or heard from in 3 weeks. His home was covered in several feet of rubbish, rotting food, and debris and smelled intensely of rotting mould, urine, and faeces. He was found lying nude on top of garbage with a rug over him. Diogenes syndrome is highly comorbid with psychiatric and somatic disorders, including depression, obsessive-compulsive disorder, personality disorder, and stress. This case report provides a rare opportunity to better understand the distinction of Diogenes syndrome from the closely related condition hoarding disorder. Furthermore, creating an agreed-upon constellation of symptoms representative of Diogenes is essential to creating a formal Diagnostic and Statistical Manual of Mental Disorders (DSM) entry, which would facilitate the much-needed development of assessment measures to enable accurate diagnosis and treatment.

scholarly journals Diogenes Syndrome and Pathological Hoarding Behaviour: A Case Report

2009 ◽  
Vol 24 (S1) ◽  
pp. 1-1 ◽  
Author(s):  
L.C. Castro ◽  
O. Ribeiro
Keyword(s):  
Social Withdrawal ◽  
Future Research ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Somatic Disorders ◽  
Diogenes Syndrome ◽  
End Stage ◽  
The Impact

Background:Diogenes syndrome is the combination of severe self-neglect, domestic squalor, social withdrawal, a tendency to hoard excessively, and refusal of help, in elderly patients.Aim:To report a case of Diogenes’ syndrome underlying the impact of pathological hoarding behaviour in the quality of life of the patient. to discuss the pathological hoarding behaviour (syllogomania) in the context of this specific behavioural disorder.Methods:Case study and review of the literature.Results:The subject of this case study is a 78-year-old man with Diogenes syndrome. Hoarding behaviour is the major presentation symptom in this case, along with domestic squalor and social withdrawal. He has marked obsessive personality traits, no insight for his morbid condition and an attitude of refusal of treatment.Discussion:The literature reveals high comorbidity of Diogenes syndrome with psychiatric and somatic disorders. Some authors raise the possibility that obsessive-compulsive disorder may be the cause of hoarding rubbish in those cases of Diogenes syndrome in which hoarding exists and cannot be better explained by other psychopathology. other authors hypothesise Diogenes syndrome as a reaction to stress in elderly people with certain personality characteristics or as the end stage of a personality disorder. the ethiopathogeny of Diogenes syndrome remains unclear and there is no consensus about diagnostic criteria. It is a relevant area for future research, contributing for a better comprehension of the differential diagnosis of pathological hoarding behaviour and late life psychopathology.

Structured Interview for Hoarding Disorder (SIHD)

2019 ◽  
Vol 35 (4) ◽  
pp. 512-520
Author(s):  
Caterina Novara ◽  
Paolo Cavedini ◽  
Stella Dorz ◽  
Susanna Pardini ◽  
Claudio Sica
Keyword(s):  
Convergent Validity ◽  
Structured Interview ◽  
Diagnostic Process ◽  
Schizophrenia Spectrum Disorders ◽  
Clinical Environment ◽  
Obsessive Compulsive ◽  
Rater Reliability ◽  
Hoarding Disorder ◽  
Compulsive Disorder ◽  
Schizophrenia Spectrum

Abstract. The Structured Interview for Hoarding Disorder (SIHD) is a semi-structured interview designed to assist clinicians in diagnosing a hoarding disorder (HD). This study aimed to validate the Italian version of the SIHD. For this purpose, its inter-rater reliability has been analyzed as well as its ability to differentiate HD from other disorders often comorbid. The sample was composed of 74 inpatients who had been diagnosed within their clinical environment: 9 with HD, 11 with obsessive-compulsive disorder (OCD) and HD, 22 with OCD, 19 with major depressive disorder (MDD), and 13 with schizophrenia spectrum disorders (SSD). The results obtained indicated “substantial” or “perfect” inter-rater reliability for all the core HD criteria, HD diagnosis, and specifiers. The SIHD differentiated between subjects suffering from and not suffering from a HD. Finally, the results indicated “good” convergent validity and high scores were shown in terms of both sensitivity and specificity for HD diagnosis. Altogether, the SIHD represents a useful instrument for evaluating the presence of HD and is a helpful tool for the clinician during the diagnostic process.

Hoarding Disorder

2017 ◽  
Author(s):  
Christine Lochner ◽  
Dan Stein ◽  
Eileen Thomas
Keyword(s):  
Key Words ◽  
Obsessive Compulsive Disorder ◽  
Obsessive Compulsive ◽  
Related Disorder ◽  
Statistical Manual ◽  
Hoarding Disorder ◽  
Compulsive Disorder ◽  
Diagnostic And Statistical Manual

Hoarding disorder is characterized by an obsessive need to acquire, collect, or keep possessions and difficulty in organizing and discarding, resulting in accumulation of clutter, which elicits great concern from family and friends. Functioning is usually impaired in a variety of domains. Obsessive-compulsive disorder is the disorder most closely associated with hoarding. Overvalued ideation regarding the value or usefulness of possessions may make it impossible for individuals to discard items. This review contains 1 table, and 22 references. Key words: clutter, diagnostic and statistical manual, etiology, hoarding, obsessive-compulsive and related disorder

scholarly journals Differential patterns of brain activation between hoarding disorder and obsessive-compulsive disorder during executive performance

2019 ◽  
Vol 50 (4) ◽  
pp. 666-673
Author(s):  
Maria Suñol ◽  
Ignacio Martínez-Zalacaín ◽  
Maria Picó-Pérez ◽  
Clara López-Solà ◽  
Eva Real ◽  
...  
Keyword(s):  
Obsessive Compulsive Disorder ◽  
Brain Activation ◽  
Anterior Cingulate ◽  
Error Processing ◽  
Obsessive Compulsive ◽  
Hoarding Disorder ◽  
Compulsive Disorder ◽  
Executive Performance ◽  
Response Switching ◽  
The Right

AbstractBackgroundPreliminary evidence suggests that hoarding disorder (HD) and obsessive-compulsive disorder (OCD) may show distinct patterns of brain activation during executive performance, although results have been inconclusive regarding the specific neural correlates of their differential executive dysfunction. In the current study, we aim to evaluate differences in brain activation between patients with HD, OCD and healthy controls (HCs) during response inhibition, response switching and error processing.MethodsWe assessed 17 patients with HD, 18 patients with OCD and 19 HCs. Executive processing was assessed inside a magnetic resonance scanner by means of two variants of a cognitive control protocol (i.e. stop- and switch-signal tasks), which allowed for the assessment of the aforementioned executive domains.ResultsOCD patients performed similar to the HCs, differing only in the number of successful go trials in the switch-signal task. However, they showed an anomalous hyperactivation of the right rostral anterior cingulate cortex during error processing in the switch-signal task. Conversely, HD patients performed worse than OCD and HC participants in both tasks, showing an impulsive-like pattern of response (i.e. shorter reaction time and more commission errors). They also exhibited hyperactivation of the right lateral orbitofrontal cortex during successful response switching and abnormal deactivation of frontal regions during error processing in both tasks.ConclusionsOur results support that patients with HD and OCD present dissimilar cognitive profiles, supported by distinct neural mechanisms. Specifically, while alterations in HD resemble an impulsive pattern of response, patients with OCD present increased error processing during response conflict protocols.

Schizophrenia, bipolar disorder, obsessive–compulsive disorder, and personality disorder

2010 ◽  
pp. 5324-5328
Author(s):  
Stephen Lawrie
Keyword(s):  
Bipolar Disorder ◽  
Personality Disorder ◽  
Social Isolation ◽  
Negative Symptoms ◽  
Social Withdrawal ◽  
Positive Symptoms ◽  
Everyday Experience ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Flat Affect

Schizophrenia—is characterized by phenomena that qualitatively differ from everyday experience. These may be ‘positive symptoms’, commonly auditory hallucinations and/or bizarre delusions, or ‘negative symptoms’, commonly including a loss of emotion (flat affect), apathy, self-neglect, and social withdrawal. Acute positive symptoms generally respond well to any antipsychotic drug, but prognosis is often poor, with most suffering chronic symptoms, numerous relapses, unemployment, and social isolation....

Testing the validity and acceptability of the diagnostic criteria for Hoarding Disorder: a DSM-5 survey

2011 ◽  
Vol 41 (12) ◽  
pp. 2475-2484 ◽  
Author(s):  
D. Mataix-Cols ◽  
L.. Fernández de la Cruz ◽  
T. Nakao ◽  
A. Pertusa
Keyword(s):  
Diagnostic Criteria ◽  
Sensitivity And Specificity ◽  
Diagnostic Category ◽  
High Sensitivity ◽  
Obsessive Compulsive ◽  
Hoarding Disorder ◽  
Compulsive Disorder ◽  
Dsm 5 ◽  
The Individual ◽  
Development And Validation

BackgroundThe DSM-5 Obsessive-Compulsive Spectrum Sub-Workgroup is recommending the creation of a new diagnostic category named Hoarding Disorder (HD). The validity and acceptability of the proposed diagnostic criteria have yet to be formally tested.MethodObsessive-compulsive disorder/hoarding experts and random members of the American Psychiatric Association (APA) were shown eight brief clinical vignettes (four cases meeting criteria for HD, three with hoarding behaviour secondary to other mental disorders, and one with subclinical hoarding behaviour) and asked to decide the most appropriate diagnosis in each case. Participants were also asked about the perceived acceptability of the criteria and whether they supported the inclusion of HD in the main manual.ResultsAltogether, 211 experts and 48 APA members completed the survey (30% and 10% response rates, respectively). The sensitivity and specificity of the HD diagnosis and the individual criteria were high (80–90%) across various types of professionals, irrespective of their experience with hoarding cases. About 90% of participants in both samples thought the criteria would be very/somewhat acceptable for professionals and sufferers. Most experts (70%) supported the inclusion of HD in the main manual, whereas only 50% of the APA members did.ConclusionsThe proposed criteria for HD have high sensitivity and specificity. The criteria are also deemed acceptable for professionals and sufferers alike. Training of professionals and the development and validation of semi-structured diagnostic instruments should improve diagnostic accuracy even further. A field trial is now needed to confirm these encouraging findings with real patients in real clinical settings.

Hoarding and Animal Hoarding: Psychodynamic and Transitional Aspects

2021 ◽  
Vol 49 (1) ◽  
pp. 24-47
Author(s):  
Kevin Volkan
Keyword(s):  
Obsessive Compulsive Disorder ◽  
Repetition Compulsion ◽  
Obsessive Compulsive ◽  
Hoarding Disorder ◽  
Transitional Phenomena ◽  
Compulsive Disorder ◽  
Stage Of Development ◽  
Therapeutic Outcomes ◽  
Hoarding Behavior ◽  
Biopsychosocial Perspective

Hoarding is a disorder that has only recently begun to be understood by researchers and clinicians. This disorder has been examined from a biopsychosocial perspective and has features that overlap with obsessive-compulsive disorder as well as some unique characteristics. Hoarding disorder is widespread and maybe related to the evolution of collecting and storing resources among humans and other animals. While there have been a number of non-analytic theories related to hoarding and its treatment, psychoanalytic thinkers have rarely described the disorder or explored its underlying psychodynamics. Beginning with Freud, it is possible to understand hoarding in relationship to the vicissitudes of the anal stage of development. However, loss of a loved object, especially loss of the mother, can play an important role in the development of hoarding behavior in adults. The hoarding of inanimate items, examined from a developmental object-relations perspective, appears to involve transitional phenomena. Animal hoarding also involves transitional phenomena, but animals, which can serve as animated transitional objects, also have a repetition compulsion function. These psychodynamic characteristics are relevant for establishing a working transference with the analyst or therapist, in order to promote positive therapeutic outcomes.

Cognitive Behavioral Therapy for Hoarding Disorder in an Older Female

2020 ◽  
Vol 19 (3) ◽  
pp. 205-221
Author(s):  
Kirstin Farquhar ◽  
Roberta Caiazza
Keyword(s):  
Cognitive Behavioral Therapy ◽  
Psychological Intervention ◽  
Behavioral Therapy ◽  
Clinical Excellence ◽  
Evidence Base ◽  
Cognitive Behavioral ◽  
Obsessive Compulsive ◽  
Hoarding Disorder ◽  
Compulsive Disorder ◽  
The Individual

Relationships toward objects can be part of healthy development; however, problems develop when collecting becomes excessive or when the individual has difficulty getting rid of the accumulated items. Hoarding disorder (HD) is defined as an enduring difficulty in discarding possessions as result of a need to save these items, and significant distress linked to disposing of them. Hoarding difficulties are still covered by the clinical guidelines for obsessive-compulsive disorder (OCD) (National Institute for Health and Clinical Excellence), which recommend utilizing psychological therapy at the client’s home. The psychological intervention with the strongest evidence-base is cognitive-behavioral therapy (CBT), but dropout rates are high and difficulties still persist for more than 50% of clients, suggesting that further research is required. Although HD has a higher prevalence in older adults, there is a lack of research into the use of CBT in this population. Preliminary research suggests that adjustments should be made around the difficulties commonly faced by these individuals. This case report outlines the use of CBT to treat “Lucy,” a 67-year-old female with HD complicated by other mental health and physical health difficulties. The case reflects on adaptations that could be made to the existing CBT model.

Diogenes' syndrome — a load of old rubbish?

1997 ◽  
Vol 14 (3) ◽  
pp. 99-102 ◽  
Author(s):  
Lynne M Drummond ◽  
Joanne Turner ◽  
Steven Reid
Keyword(s):  
Obsessive Compulsive Disorder ◽  
Beck Depression Inventory ◽  
Post Treatment ◽  
Response To Treatment ◽  
Psychiatric Diagnoses ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Diogenes Syndrome ◽  
Previous Series

AbstractObjective: It has been suggested that presentation with self-neglect, domestic squalor and hoarding, represents a distinct syndrome, widely known as Diogenes' syndrome. The validity of this syndrome is controversial and we suggest that in previous series of such patients other psychiatric diagnoses, particularly obsessive compulsive disorder (OCD), may have been missed.Method: A series of 50 patients admitted for treatment of OCD were examined, looking for presentation with self-neglect, domestic squalor and hoarding. Response to treatment was also measured by comparing pre and post-treatment scores on the Beck Depression Inventory and Activity Checklist.Results: Of the sample 8% presented with all three features. This sub-group of patient had a poorer outcome than other patients with OCD.Conclusion: Presentation with self-neglect, domestic squalor and hoarding is not uncommon in patients with severe OCD and this supports the suggestion that patients previously described as having Diogenes' syndrome may have had undiagnosed OCD.

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