Diogenes of Sinope was a 4th-century BC Greek minimalist philosopher, and one of the early cynics who advocated the principles of self-sufficiency and contentment unrelated to material possessions. He lived as he preached, sleeping rough in public buildings (some believe in a barrel) and begging for food, thus reducing his earthly needs to the barest minimum. His ideals were “life according to nature,” “self-sufficiency,” “freedom from emotion,” “lack of shame,” “outspokenness,” and “contempt for social organization.” The name of the syndrome is a reference to the reclusiveness and rejection of the outside world practiced by the philosopher. The underlying motivation of the syndrome appears to be a suspicious rejection of the world, rather than a desire to demonstrate self-sufficiency without material possessions.
The eponym was first suggested in 1975 by Clark and collaborators, who described 30 geriatric patients with personalities characterized by suspiciousness, aloofness, hostility, and unfriendliness admitted to hospital in a state of severe self-neglect, and who were living in gross domestic squalor. It was, however, MacMillan and colleagues (1966) who conducted the first thorough investigation. They called the syndrome senile breakdown. It is also known as self-neglect, senile squalor,6 or social withdrawal in the elderly, and it has also been referred to in the German literature as messy house syndrome, and the victims, somewhat quaintly, as messies. Acute, transient periods of social withdrawal and neglected selfcare, such as in grief, are not included in the pure DS category; socially sanctioned patterns of withdrawal (monks, ascetics, etc), which are the result of a conscious decision based on ideological principles, are also not regarded as cases of DS.
Classical constellation of symptoms:
- Extreme neglected physical state
- Social isolation
- Domestic squalor
- Syllogomania: tendency to hoard excessively