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Revista Portuguesa de Saúde Pública

Print version ISSN 0870-9025


ALMEIDA, Rosa  and  RIBEIRO, Oscar. Diogenes syndrome: systematic literature review. Rev. Port. Sau. Pub. [online]. 2012, vol.30, n.1, pp.89-99. ISSN 0870-9025.

Background: Diogenes Syndrome (DS) presents a growing international interest in clinical, social and public health research areas. It is characterized by a break and rejection of social patterns observed in a severe negligence in personal and environmental care, in a gradual isolation, in a reduced insight and in the accumulation behavior. Many theoretical explanations have been presented but none covers entirely the complexity associated with the syndrome. Objective: Contribute to the systematization of scientific evidence about DS and to raise national awareness among clinical and social professionals for this syndrome. Methods: The literature on DS was comprehensively reviewed [1960-2010] in English, French, Spanish and Portuguese languages, supplemented with research of associated nomenclature. 109 documents were considered for analysis and of these 67 case reports were collected and analysed by a grid built for that purpose. Results: DS was found to be more common in older subjects (84%), single individuals (44%), who were living alone (64%) and in an apartment. DS cases were usually referenced by neighbors to the health care system as a result of a hazard to themselves or others. The determining criteria for the identification of the syndrome were social isolation and physical and domestic self-neglect. Two thirds of the reports described psychiatric diagnoses that appeared to contribute to the presentation of the DS. Discussion: DS is presented as a true syndrome that combines a multifactorial etiology. This entity seems to present a unique age-related feature, characterized by the manifestation of a different range of precipitating factors, supporting the argument that DS should be considered as a geriatric syndrome. Main obstacles to intervention are isolation and the refusal of formal support that seems to reveal a mismatch between the needs of these individuals and the way services are provided.

Keywords : Diogenes syndrome; Extreme self-neglect; Squalor syndrome.

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