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Mental retardation
Published in Ben Green, Problem-based Psychiatry, 2018
John differs in two ways: he has a persistently low level of intelligence and recently has developed signs of mental illness. The details of his case are incomplete, but they do point towards various difficulties: coping with schoolwork, socialising with peers and restricted areas of interest. These would be consistent with mild mental retardation, although the history above gives no hint as to the aetiology of this. (It is possible for mildly retarded people to make their way through regular school, although they perhaps do not progress to such levels as their peers and may find difficulties in gaining employment in a very competitive and technologically orientated job market. In school it is important to recognise learning difficulties so that teaching strategies can be adjusted to maximise the individual’s potential. It is important to distinguish between specific learning difficulties, e.g. numerical skills, and more global cognitive disabilities.) Against this background of mild mental retardation, John is exhibiting some signs of mental disorder such as social withdrawal, compulsive hoarding and possible hallucinations which might make a doctor consider whether John was developing schizophrenia or had an affective disorder. Certainly a referral would be appropriate to either an adult psychiatrist or a psychiatrist specialising in learning disability.
Downsizing - Confronting Our Possessions in Later Life by David J. Ekerdt
Published in Journal of Gerontological Social Work, 2021
It is important to note that this book does not focus on individuals who struggle with hoarding behaviors as these behaviors are “outside the bounds of normal possession management,” and the author confirms that his team did not encounter compulsive hoarding in the households they visited. However, those familiar with Hoarding Disorder will recognize some classic cognitive and behavior patterns described in the interviews, such as difficulty with time management, decision-making, anxiety, and depression. For example, the author discloses nine reasons why people keep things: useful now; might be useful in the future; worth money; gives pleasure; represents us; conjures the past or future; received as gifts; represents ancestry; and simply because we can. These are the very reasons a person struggling with hoarding behaviors will use to explain why they are unable to discard an item. Such crossover thought and action processes do not indicate those interviewed have hidden hoarding behaviors. The distinction lies in the ability to follow through to discarding – the ability to get past the reasons to keep, manage any related stress and anxiety, and successfully discard an item.
Introduction to the Special Issue on Rare and Unusual Syndromes
Published in Neuropsychological Rehabilitation, 2018
Michael Perdices, Barbara A. Wilson
The case of TD, presented in the paper “TD: The case of Diogenes Syndrome – Deficit or denial?” (pp. 244–258), illustrates the role of and complex interaction between factors that may underlay Diogenes Syndrome: cognitive impairment, awareness and emotional functioning. Diogenes Syndrome, otherwise known as Senile Squalor Syndrome, is characterised by extreme self-neglect, squalor, withdrawal, apathy, compulsive hoarding and lack of shame. It is associated with a range of conditions including frontal lobe dementia and learning disability. The primary question addressed in this paper is to what extent is the man denying his problems and to what extent is there an actual deficit in his ability to experience shame and recognise disgust.
Capgras and Fregoli syndromes: delusion and misidentification
Published in International Review of Psychiatry, 2020
Antonio Ventriglio, Dinesh Bhugra, Domenico De Berardis, Julio Torales, João Mauricio Castaldelli-Maia, Andrea Fiorillo
In elderly patients, the coexistence of Capgras delusion and Diogene’s Syndrome, characterised by senile squalor, self-neglect, social withdrawal, compulsive hoarding of garbage or animals and apathy, has been described (Nabi, 2001). Also, Capgras-like transient delusional conditions have been recognised during some cocaine or ketamine intoxication states (Corlett et al., 2010; Mercurio, 2011). Misidentification delusions are common during some delirium states due to medical conditions or drug intoxication as well: some authors described Capgras delusions in patients reporting chronic intoxication with lithium, occurring with serum lithium levels upper than 1.12 mEq/L and lower than 2.18 mEq/L (Nagasawa, Hayashi and Otani, 2012).