Diogenes Syndrome: Causes, Symptoms & Treatment

Instructor: Adrianne Baron

Adrianne has taught high school and college biology and has a master's degree in cancer biology.

There are many behavioral disorders that are not completely understood. One is Diogenes Syndrome. We will go over the possible causes, symptoms and treatment options in this lesson.

Diogenes Syndrome

You are about to complete your first week at work at the behavioral rehabilitation center. It has been enjoyable and you are applying what you learned in school. You receive the chart for a new patient, John, that is coming in to be treated. John has Diogenes Syndrome. This is a behavioral disorder characterized by neglecting self-care, hoarding and social isolation. You ask one of the behavioral therapists, Michelle, about the syndrome since you are not familiar with it. Michelle lets you know that it is one of the many behavioral disorders that is not clearly understood, but she will give you some basics so you have more background information.


Michelle begins by letting you know that there are several names that you may hear that all refer to this same syndrome. Those names include: senile squalor syndrome, self-neglect syndrome, messy house syndrome, and severe social breakdown syndrome. The first thing you ask Michelle about is the cause of the development of Diogenes Syndrome. Michelle says that is one of the parts they do not understand.

It appears that some people develop it spontaneously, which is called Primary Diogenes Syndrome, while others develop it due to other mental health conditions, in which case it is called Secondary Diogenes Syndrome. One of the most common mental conditions associated with Diogenes is dementia, which is severe memory loss due to aging.

Other medical problems that have been recorded as possibly causing Diogenes are things such as vision problems, depression, congestive heart failure, and stroke. There are other times that certain events, such as trauma or death of a close loved one, can be the trigger which activates the disorder. Michelle emphasizes that there is just not enough information to definitively say what causes people to develop Diogenes Syndrome.


You admit to Michelle that you are having a hard time thinking about the symptoms that may develop as part of this disorder. Michelle lets you know you are not alone because not only do the symptoms appear on the person with the disorder, but the symptoms are observed in their home and social interactions.

The first set of symptoms that other people may begin to notice early in the development of Diogenes, is that the person becomes very withdrawn from family, friends, and associates. They may also start to make poor choices when they usually make sound ones. A person with Diogenes may begin to behave in strange or improper manners and show an overall change in their demeanor and personality.

Michelle tells you that some of the later symptoms may include very bad body odor as if the person has not bathed in months. They may also have skin rashes from poor hygiene, matted hair, and poor nutrition.

Hoarding is one of the indicators of Diogenes Syndrome
Picture of hoarding in a living room

Symptoms in the home include excessive hoarding (accumulating excessive amounts of items), keeping an extremely dirty home that stinks potentially with bugs and rats, and complete denial or lack of care about how their home looks. They will almost completely isolate themselves, not trust anyone, become suspicious of everyone, exhibit extreme anxiety when around others, become dissociated with reality, and display aggression and hostility toward anyone with whom they interact, especially health care workers.


Now that you have even more information, you look at Michelle and ask, ''How in the world are we going to treat John for this disorder?'' Michelle says that it is definitely an uphill battle to treat this disorder largely because John likely does not know he has the disorder. People with this disorder are usually in denial about the disorder.

Michelle says that the doctor will assess John to see if the underlying cause of his case can be determined. His treatment will be based on any possible causes, his ability to help with his care, and other psychological conditions from which he may be suffering. The doctor could prescribe anxiety or other psychological drugs to help decrease or get rid of the symptoms.

Support groups are often used to help treat social symptoms of Diogenes
Picture of a support group meeting

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