Das Diogenes-Syndrom

Abstract

Endogenous or physically conditioned psychoses are usually considered to be the underlying cause of signs of extreme self-neglect and social retreat if these occur suddenly in persons who had been socially successful up to that time. However, in recent years several independent researchers have found extreme sociocultural refusal attitudes even in patients not displaying any psychotic disturbances. This unexpected result led to a new syndrome concept which has since been accepted internationally under the designation "Diogenes syndrome". Hence, the Diogenes syndrome comprises shameless neglect of body and personal environment, associated with collectionism, social retreat and rejection of any well-meant help. It has been reported that this constellation of signs allegedly occurs with enhanced frequency in women over 60 years of age with self-isolation tendencies in their previous life history. The following article reviews the literature published so far on the Diogenes syndrome and presents two cases treated by the authors, as a suitable means to re-examine and to define the new syndrome concept more precisely. The following conclusions can be drawn from the cases already reported in the literature and the two cases newly presented here: The socioculturally complete rejection associated with the Diogenes syndrome is the final result of a personality-based abnormal emotional reaction development. Marked seclusion tendencies in the previous life history, as well as organic brain diseases, are relevant. Medical treatment can be successful mainly by means of behaviour therapy techniques.

Is collectionism a diagnostic clue for Diogenes syndrome?

“…A previous report has identified 'collectionism' as a part of the complex entity of DS; however, the strength of this association and the difference with the hoarding of rubbish is still unclear (Klosterkotter and Peters, 1985). Briefly, a collector is defined as a person who collects things for a specific purpose be it hobby, business or personal satisfaction.…”

Vermüllung

“…"Vermüllungssyndrom" sind Begriffe, die in der deutschsprachigen Literatur ab 1985 in Gebrauch kamen, um Zustände schwerer Verwahrlosung zu bezeichnen [2,5,6,8]. Manche halten die Benennung für pejorativ, andere überhaupt für überflüssig, zumal es im internationalen Schrifttum keine genaue Entsprechung gibt.…”

“…Nicht zufällig tritt Vermüllung oft im Alter auf, wenn die Energie fehlt, die akkumulierten Gegenstände ab und zu wegzuräumen. In der internationalen gerontopsychiatrischen Literatur wird dafür der Begriff "Diogenes-Syndrom" [6] verwendet, den einige Autoren inzwischen aber ablehnen.…”

Eine Studie über Personen mit Verwahrlosung, Vermüllung oder Horten

“…1984 prägte der Hamburger Psychiater Dettmering den Terminus "Vermüllungssyndrom" [6], der daraufhin in der Mehrzahl der folgenden deutschen Arbeiten [7 -13] zu diesem Thema benutzt wurde. 1985 übernahmen Klosterkötter und Peters [14] das nosologisch ähnliche Konzept des "DiogenesSyndroms", das auf Clark, Mankikar und Gray [15] zurückgeht, anhand eigener Untersuchungen in das deutsche Schrifttum. Im Jahr 2000 entwickelten Halliday et al [16] basierend auf den Arbeiten von Macmillan und Shaw [17] und Samios [18] einen Score, mit dessen Hilfe Aussagen über das quantitative Ausmaß der Verände-rung von Lebensbedingungen möglich wurden.…”