Síndrome de Diógenes: revis？o sistemática da literatura

background: diogenes syndrome (ds) presents a growing international interest in clinical, social and public health research areas. it is characterized by a break and rejection of social patterns observed in a severe negligence in personal and environmental care, in a gradual isolation, in a reduced insight and in the accumulation behavior. many theoretical explanations have been presented but none covers entirely the complexity associated with the syndrome. objective: contribute to the systematization of scientific evidence about ds and to raise national awareness among clinical and social professionals for this syndrome. methods: the literature on ds was comprehensively reviewed [1960-2010] in english, french, spanish and portuguese languages, supplemented with research of associated nomenclature. 109 documents were considered for analysis and of these 67 case reports were collected and analysed by a grid built for that purpose. results: ds was found to be more common in older subjects (84%), single individuals (44%), who were living alone (64%) and in an apartment. ds cases were usually referenced by neighbors to the health care system as a result of a hazard to themselves or others. the determining criteria for the identification of the syndrome were social isolation and physical and domestic self-neglect. two thirds of the reports described psychiatric diagnoses that appeared to contribute to the presentation of the ds. discussion: ds is presented as a true syndrome that combines a multifactorial etiology. this entity seems to present a unique age-related feature, characterized by the manifestation of a different range of precipitating factors, supporting the argument that ds should be considered as a geriatric syndrome. main obstacles to intervention are isolation and the refusal of formal support that seems to reveal a mismatch between the needs of these individuals and the way services are provided.