[Diogenes's syndrome: an observatory study in a Paris district].

Introduction: Diogenes syndrome, DS, is a behavioral disorder affecting more often older adults. It is a controversial syndrome with at least 4 almost permanent symptoms: no request from the subject although he possesses nothing; unusual relationship with objects (hoarding of rubbish, or nothing in the house); unusual relationship with people (misanthropy) and extreme self-neglect. Difficulties in taking care of such subjects has conducted the socio-medical team to carry out a descriptive study to find out if these subjects had a pathological state or not.

Method: A retrospective observatory survey based on 600 questionnaires sent to medical and social workers to describe potential cases of DS.

Results: 136 questionnaires concerning 121 subjects have been completed by 53 professional workers, which represent 1.6 case for 10,000 individuals. Mean age of the subjects was 77.8 +/- 9.9 years (range 52 to 95); 71% were women. All socio professional categories were represented among the patients. Half of the patients had a psychiatric disorder and 26% a dementia; 7% were alcohol addicts. One forth of DS had no associated mental pathology, and could be primary, but a "queer" personality was reported in these cases and a traumatism during childhood in 12%.

Conclusion: The variety of the clinical typology may explain the controversial data on the literature about the relevance of this syndrome. We propose 14 different types according to the present symptoms, and eventual associated mental pathology. In primary SD, without associated psychiatric pathology, an "exceptional" personality and, in 12% of cases, a traumatism during childhood were reported. These results may help designing a future prospective study.