DIOGENES-SYNDROME - A LOAD OF OLD RUBBISH

Objective: 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 controve rsial and we suggest that in previous series of such patients other ps ychiatric diagnoses, particularly obsessive compulsive disorder (OCD), may have been missed. Method: A series of 50 patients admitted for tr eatment of OCD were examined, looking for presentation with self-negle ct, domestic squalor and hoarding. Response to treatment was also meas ured 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 outco me than other patients with OCD. Conclusion: Presentation with self-ne glect, domestic squalor and hoarding is not uncommon in patients with severe OCD and this supports the suggestion that patients previously d escribed as having Diogenes' syndrome may have had undiagnosed OCD.