Le syndrome de Diogène : description clinique et conduite à tenir

Diogenes' syndrome corresponds to several neurological pathologies (frontotemporal dementia more often than Alzheimer's), psychiatric pathologies (late onset psychosis rather than early onset), as well as to patients with peculiar personalities for which the paraclinical assessment is too scant to allow the physician to complete the diagnosis. The main issue raised by these patients is their always late spotting, combined with a difficult follow-up due to the intricacy of social and ethical issues. Diogenes' syndrome clinic can be resumed as a single main criterion (lack of request for help from social and medical workers), combined with at least one secondary criteria (a pathological relationship to objects, to one's body and to other people). This article proposes a diagnostic procedure based on cross-examination and additional tests, a “therapeutic” approach, and a few ethical rules to help the clinician in his care pathway.