What is Diogenes syndrome, its symptoms and its treatment?

The observation of repeated cases of people with extremely sullen behaviour who lived secluded in their homes and avoided contact with other people led to a scientific study in the 1960s that detailed this behaviour pattern.

In 1975 it was baptised the Diogenes Syndrome, about Diogenes of Sinope, a philosopher from the time of Aristotle famous for advocating an austere way of life and giving up all kinds of comforts.

People with Diogenes syndrome accumulate large amounts of garbage and waste in their homes. 


Diogenes syndrome affects, above all, people over 65 years of age. Still, it is usually a disease that appears as a consequence of other previous pathologies, such as obsessive-compulsive personality disorder, or due to other behaviours that can be aggravated, such as collecting or other causes.

At least half of patients with this disease suffer from some kind of mental illness: the most frequent related diagnoses are dementia, psychotic depression and personality disorders.

This disease is more common in women than in men, especially in those who are widows. 


Social isolation,  confinement in one’s own home and neglect of hygiene are the main behaviour patterns. People who suffer from it can accumulate large amounts of garbage in their homes and live voluntarily in conditions of extreme poverty.

The patient usually shows absolute negligence in his self-care and home cleaning.

In addition, they can collect large amounts of money at home or in the bank without knowing what they have. On the contrary, they think they lack financial resources, which leads them to save and keep items that are useless. As a result, they often store large amounts of garbage and waste that are unusable.

Patients suffering from this disease lack awareness of it and often reject any external help. They do not know how to give arguments to explain their behaviour, and, in some cases, they are psychotic. Cognitive and social functions are altered, and no pattern is found when accumulating things. 


It is important to monitor the family to prevent this type of pathology. That is control and observation, especially for older people who live alone.

Special attention should be paid in cases where the person tends to isolate or begins to be careless. 


The types of Diogenes syndrome are differentiated based on what is the cause that causes them: on the one hand, it occurs in people who do not have other diagnosed psychiatric pathologies, and on the other hand, in those people who suffer from chronic psychiatric disorders such as depressed, delusional, or demented. 


To diagnose this disease, the family must inform about the situation since the patient will not do it alone. In the same way, the specialist must, in the first place, detect if he suffers from Diogenes syndrome or, on the contrary, it is only an obsessive-compulsive personality disorder.

Patients with the second pathology usually have an ego-syntonic behaviour and, in most cases, allege the potential usefulness of the objects they keep. It differs from Diogenes syndrome in that it is usually a behaviour that does not go beyond the limits of his private life, so his family environment only knows it. 

Therefore, it is essential to monitor the patient to observe their behaviour patterns and thus detect the disease since this syndrome has a 46 per cent mortality rate in the five years following diagnosis.


In the first instance, the treatment for these people is aimed at treating possible complications derived from poor nutritional and hygienic status. However, immediately afterwards, it is necessary to establish preventive measures so that the picture does not repeat itself. This requires sufficient social support or home care and avoids hospitalisation.

The problem is that those affected often reject social assistance. However, suppose they are not incapacitated due to some basic psychiatric pathology or dementia. In that case, they cannot be admitted without their consent, so they end up returning to their previous type of life.

Other data

It usually occurs in elderly people with a certain tendency towards isolation. However, other stressful factors of late age are also involved, such as economic difficulties or the death of a family member, and above all,  loneliness.

The socioeconomic position does not protect from its appearance since there are cases of people who suffered from the syndrome who had university degrees, a high economic level and brilliant professional careers.

advice to families

Family members should monitor their elders who live alone,  especially if they have observed any risk factors, such as sullen behaviour or self-isolation.

However, it is often difficult to help them since they are the ones who avoid all kinds of attention. Sometimes, it is debated whether it is a disease or just a lifestyle.