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Diogenes syndrome and autistic spectrum disorder

Published online by Cambridge University Press:  13 June 2014

Matthew Sadlier
Affiliation:
Department of Psychiatry, St Vincent's University Hospital, Dublin 4
Colm Cooney
Affiliation:
Department of Old Age Psychiatry, Carew House, St Vincent's University Hospital, Dublin 4, Ireland
Eimer Philbin-Bowman
Affiliation:
Dublin Well Woman Centre, Ballsbridge, Dublin 4
Aideen Lewis
Affiliation:
Department of Old Age Psychiatry, Carew House, St. Vincent's University Hospital, Dublin 4, Ireland

Abstract

Diogenes syndrome or senile squalor syndrome has been described in the psychiatric literature with an associated mental illness in between one half and two thirds of the cases cited. The occurrence of the syndrome in the absence of a psychiatric disorder has received much attention with many hypotheses proposed. We present the case of a 72-year-old man living for many years in domestic squalor whose presentation, neuropsychological profile and history suggest an underlying autistic spectrum disorder. We are not aware of any similar case in an older adult reported in the medical literature. The co-occurrence of these two conditions is an intriguing one as certain key features of autistic spectrum disorder may predispose to Diogenes syndrome.

Type
Case reports
Copyright
Copyright © Cambridge University Press 2011

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References

1.Macmillan, D, Shaw, P. Senile breakdown in standards of personal and environmental cleanliness. BMJ 1966; 2: 1032–7.CrossRefGoogle ScholarPubMed
2.Snowdon, J, Shah, A, Halliday, G. Severe domestic squalor: a review. Int Psychogeriatrics 2007; 19(1): 137–51.CrossRefGoogle ScholarPubMed
3.Pertusa, A, Frost, R, Fullana, Met al.Refining the diagnostic boundaries of compulsive hoarding: a critical review. Clin Psychol Rev 2010; 30: 371–80.CrossRefGoogle ScholarPubMed
4.Halliday, G, Banerjee, S, Philpot, M, Macdonald, A. Community study of people who live in squalor. Lancet 2000; 355: 882–6.CrossRefGoogle ScholarPubMed
5.Shaw, T, Shah, A. Squalor syndrome and psychogeriatric admissions. Int Psychogeriatrics 1996; 8(4): 669674.CrossRefGoogle ScholarPubMed
6.James, I, Mukaetova-Ladinska, E, Reichelt, K, Briel, R, Scully, A. Diagnosing Aspergers syndrome in the elderly: a series of case presentations. Int J Geriatr Psychiatry 2006; 21: 951–60.CrossRefGoogle ScholarPubMed
7.Clark, A, Mankikar, G, Gray, I. Diogenes syndrome: a clinical study of gross neglect in old age. Lancet 1975; i: 366–8.CrossRefGoogle Scholar
8.Wrigley, M, Cooney, C. Diogenes syndrome – an Irish series. Ir J Psychol Med 1992; 9: 3741.CrossRefGoogle Scholar
9.Snowdon, J. Uncleanliness among persons seen by community health workers. Hosp Comm Psych 1987; 38: 491494.Google ScholarPubMed
10.Scallan, E, De La Harpe, D, Johnson, H, Hurley, M. Adult service refusers in the greater Dublin area. Ir Med J 2000; 9: 208211.Google Scholar
11.Orrell, MW, Sahakian, BJ, Bergmann, K. Self-neglect and frontal lobe dysfunction. Br J Psych 1989; 155: 101105.CrossRefGoogle ScholarPubMed
12.Baron-Cohen, S. Commentary. Evidence Based Mental Health 2007; 10: 28CrossRefGoogle Scholar
13.Wing, L. Aspergers syndrome: a clinical account. Psychol Med 1981; II: 115130.CrossRefGoogle Scholar
14.Attwood, T. The Complete Guide to Asperger Syndrome. Jessica Kingsley publisher, 2006.Google Scholar
15.Philbin-Bowman, E. Asperger's syndrome and autism: the case for a connection. Br J Psych 1988; 152: 377382.CrossRefGoogle Scholar
16.Bejerot, S. An autistic dimension: a proposed subtype of obsessive-compulsive disorder. Autism 2007; 11(2): 101110.CrossRefGoogle ScholarPubMed
17.Chen, PS, Chen, SJ, Yang, YK, Yeh, TL, Chen, CC, Lo, HY. Asperger's disorder: a case report of stealing and collecting behaviours of an adolescent patient. Acta Psychiatr Scand 2003; 107(1): 7376.CrossRefGoogle ScholarPubMed
18.Ruta, L, Mugno, D, D'Arrigo, VG, Vitello, B, Mazzone, L. Obsessive-compulsive traits in children and adolescents with Asperger's syndrome. Eur Child Adol Psychiatry 2010, 1: 1724.CrossRefGoogle Scholar
19.Oppenheimer, C. Personality in later life: personality disorder and the effects of illness on personality. 4th Ed. Oxford textbook of Old Age Psychiatry 2007: 612614.Google Scholar
20.WHO. Schedules for Clinical Assessment in Neuropsychiatry. Geneva: WHO, 1992.Google Scholar
21.Woodbury-Smith, MR, Robinson, J, Wheelwright, S, Baron-Cohen, S. Screening adults for Asperger syndrome using the AQ: A preliminary study of its diagnostic validity in clinical practice. J Autism Develop Dis 2005; 35(3): 331335.CrossRefGoogle ScholarPubMed
22.Grace, J, Malloy, PF. Frontal Systems Behaviour Scale (FrSBe): Professional Manual. Lutz, FL: Psychological Assessment Resources, 2001.Google Scholar
23.Keane, B. Senile squalor syndrome. Letter to J Roy Soc Med 1999; 92: 438.CrossRefGoogle ScholarPubMed