Pages: 5 (1081 mots) Publié le: 18 avril 2009
History Clark and al in 1975, in a study concerning 30 patients of more than 65 years hospitalized for a pointed pathology and for an extreme carelessness of themselves, described patients living in conditions of major dirt, accumulating any sorts of useless objects and garbage in their housing environment. They considered this behavioural problem as a syndrome which they baptized: " syndromeof Diogene ". This terminology makes reference to the famous Greek philosopher of the IVth century before J.C, Diogène, leader of the cynics and the follower of Socrates. This last one, dirty with the long and untidy hair, lived in a barrel and disdained the social agreements by expressing its disdain for the humanity. He had for the only things only a coat and a shoulder bag. Such was its choiceof life. clinical From the various works, it is possible to define the clinical characteristics of the syndrome of Diogene: A behavior of carelessness of the personal hygiene and the place of life, A denial of the reality and an absence of shame relative to their way of living, A social isolation, A pre-morbid personality: suspicious, cunning, distant, a tendency todeform the reality, A refusal of any lived help as intrusive. Let us note that Clark added to these diagnostic criteria, the absence of cognitive changes. Ethiopathogénie In the literature, we raise various hypotheses concerning the étiopathogénie of this behavioural problem. Consequently, there is no consensus on mechanisms étiopathogéniques. Nevertheless, two currents seem tocoexist: the one which connects the syndrome with a psychiatric pathology and the other which evokes the choice of a lifestyle and the expression of the free will, just like Diogène. For Clark, who does not find psychiatric pathology nor cognitive change to half of his patients, the syndrome of Diogène would correspond to a reaction to the specific stress of the old subject, arising on apredisposed personality containing lines of anxiety, gloomy humor and attitude of retreat. This reaction would constitute an active attitude and not a passive degradation. Nevertheless, some authors as Rosenthal, formulated critics concerning this study. Indeed, on 30 inclusive patients 14 died and thus the results of the tests of intelligence and personalities reflect only those of 16 remaining patients.We can wonder about the mental state of missing half. Mac Millan and Shaw found on their population of 72 subjects, 38 psychotic patients and 34 unhurt patients of any mental pathology among which 11 presented signs of réactionnelle depression. In the more recent Anglo-Saxon literature appears a considering consensus that at least half of the patients " Diogène " suffers from psychiatricpathologies. Among the quoted disorders, we note: the insanity, the alcoholism, the paraphrénies, but also the schizophrenia to young cases, and finally OBSESSIVE-COMPULSIVE DISORDER. The study of Halliday counts 70 % of psychiatric disorders. Concerning the insanities, certain works propose the hypothesis of a dysfunction of the frontal lobe. Indeed, the frontal insanity and the syndrome of Diogèneshare common symptoms as the hostility, anosognosie and syllogomanie interpreted as shape of perseveration engine. Finally, was noticed in certain cases a secondarily insane evolution. Cannot we interpret then the syndrome of Diogène as precursor of an insanity, and underline the interest of forward-looking studies in which would be made balance sheets psychometrics and examinations of intellectualimaging? In France, Monfort, in its work of psychogériatrie, classifies the syndrome of Diogène in the neurosises of involution. A French study realized by Taurand and al ., studied the medical and social status of 21 patients of more than 60 years old living in a shanty and having been hospitalized for somatic causes. It finds a chronic éthylisme in 57 % of the cases, the signs of intellectual...
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