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Severe domestic squalor: a review
John Snowdon1, Ajit Shah, Graeme Halliday
1Discipline of Psychological Medicine, University of Sydney, and Rozelle Hospital, Sydney, Australia. jsnowdon@mail.usyd.edu.au
International Psychogeriatrics
|September 16, 2006
Summary
Severe domestic squalor cases often involve the elderly and have poor intervention outcomes. Frontal lobe changes and obsessive-compulsive disorder (OCD) may contribute to neglect and hoarding behaviors.
Area of Science:
- Geriatric Medicine
- Psychiatry
- Environmental Health
Background:
- Referrals for severe domestic squalor are frequent.
- A literature review is timely to understand these complex cases.
Purpose of the Study:
- To review existing literature on severe domestic squalor.
- To identify common characteristics, diagnoses, and potential causes.
- To explore intervention challenges and outcomes.
Main Methods:
- Comprehensive literature search across multiple databases (Medline, Psychinfo, Embase, CINAHL).
- Inclusion of reference lists from relevant publications.
- Review of over 1100 reported cases.
Main Results:
- Elderly individuals constitute half of those in severe domestic squalor.
- Intervention outcomes are frequently poor.
- Common diagnoses include dementia, alcoholism, schizophrenia, and personality disorders.
- Frontal lobe changes may link to hygiene neglect.
- Hoarding, often linked to obsessive-compulsive disorder (OCD), is present in over half of cases, distinguished from simple rubbish accumulation.
Conclusions:
- Further research is needed to understand triggers and vulnerabilities.
- Standardized ratings for living conditions are required.
- Investigating effective intervention strategies and outcomes is crucial.
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