1203 – Cognition and civil capacity in diogenes syndrome: analysis of psychiatric reports from the public attorney district of rio de janeiro

Abstract

Introduction Diogenes Syndrome (DS) refers to a collection of features found mainly in older persons which includes social isolation, self-neglect, poor insight, domestic squalor and hoarding behavior. Underlying psychiatric disorders might be identified in most of those elders. Issues of law have been embedded in DS cases, since individuals commonly expose themselves and their neighborhood to preventable health risks, due to extreme self-neglect and poor sanitation. Objective This cross-section aims to assess health-care, cognitive and civil capacity status of patients with DS, based on data from forensic-medical reports. Methods Psychiatric-forensic reports concerning to elders living alone, recorded between January 2009 to December 2010 in the archives of the Public Attorney District of the State of Rio de Janeiro, Brazil, were analyzed. Results Reports from 40 living alone elders (mean age=79.63 ± 7.84 years; mean schooling= 5.68 ± 5.43 years; 75% female) were eligible for the study. 20 individuals (50%) fulfilled diagnostic criteria for DS. DS individuals presented significantly lower mean scores in MMSE than non-DS persons (p= 0.019). More individuals with dementia were found among DS group. Fewer recent medical consultations (p= 0.038) and higher rates of civil incapacity (p= 0.001) were identified in DS elders. Negative moderate correlation was found between MMSE scores and diagnostic of DS (rho=-0.403; p= 0.016). Medical support (phi= 0.388; p= 0.016) and civil incapacity (phi= 0.554; p Conclusion DS might be related to poor cognitive status, health care neglect and impaired discernment, which may be of interest to both health and law practitioners.