Late-onset Diogenes syndrome in Chinese – an elderly case series in Hong Kong

Sau Man Sandra Chan¹, Pui Yiu Vivian Leung², Fung Kum Helen Chiu¹

¹Department of Psychiatry, The Chinese University of Hong Kong; ²Department of Psychiatry, Shatin Hospital, New Territories East Cluster, Hong Kong

Abstract: We review a consecutive case series of elders presenting to a regional psychogeriatric service in Hong Kong in 1996–2001. Eighteen elders (aged 65 and over) fulfilled the classical symptoms of Diogenes syndrome (extreme squalor, neglected physical state, unhygienic condition & social isolation with or without hoarding). A diverse clinical and socio-demographic profile was observed. Most of our clients suffered from different stages of dementia. Other diagnoses such as schizophrenia and alcohol abuse were diagnosed in this cohort as co-morbid or independent conditions. Neither psychopathology nor social situations could adequately account for the initiation and perpetuation of Diogenes syndrome in some cases. The plausible psychological etiologies are discussed in the context of existential values in Chinese culture and changes in traditional family dynamics as the society modernizes.

Keywords: Diogenes syndrome, senile squalor, social breakdown, hoarding, Chinese culture.