Diogenes syndrome is the combination of severe self-neglect, domestic squalor, social withdrawal, a tendency to hoard excessively, and refusal of help, in elderly patients.

To report a case of Diogenes’ syndrome underlying the impact of pathological hoarding behaviour in the quality of life of the patient. To discuss the pathological hoarding behaviour (syllogomania) in the context of this specific behavioural disorder.

Case study and review of the literature.

The subject of this case study is a 78-year-old man with Diogenes syndrome. Hoarding behaviour is the major presentation symptom in this case, along with domestic squalor and social withdrawal. He has marked obsessive personality traits, no insight for his morbid condition and an attitude of refusal of treatment.

The literature reveals high comorbidity of Diogenes syndrome with psychiatric and somatic disorders. Some authors raise the possibility that obsessive-compulsive disorder may be the cause of hoarding rubbish in those cases of Diogenes syndrome in which hoarding exists and cannot be better explained by other psychopathology. Other authors hypothesise Diogenes syndrome as a reaction to stress in elderly people with certain personality characteristics or as the end stage of a personality disorder. The ethiopathogeny of Diogenes syndrome remains unclear and there is no consensus about diagnostic criteria. It is a relevant area for future research, contributing for a better comprehension of the differential diagnosis of pathological hoarding behaviour and late life psychopathology.