[A study of persons living in neglect, filth and squalor or who have a tendency to hoard].
OBJECTIVE
Who develops neglect, lives in filth and squalor or tends to hoard? What happens to people with such tendencies, after heaving been discovered by community mental health services?


METHODS
During a two-year observation period it was attempted to study all such persons in the city of Halle/Saale. Life history as well as medical, social and psychiatric variables were assessed. After a mean period of 11 months these persons were re-assessed.


RESULTS
35 persons who lived in squalor and filth or in a neglected condition or who were known to hoard were assessed (60 % male, mean age: 63 years). 17 persons (49 %) suffered from an organic brain disease, 14 (40 %) fulfilled criteria of psychotic illness (mainly schizophrenia). In 9 cases a comorbid physical disorder contributed to the prevailing living conditions. After 11 months, for 21 persons (60 %) no amelioration of neglect, squalor or hoarding was observed, which was especially true for persons suffering from a psychotic illness. The results yielded some evidence that interventions, which aimed at living conditions (such as moving to sheltered accommodation), had positive effects, while this was not true for standard mental health care within community services and hospital treatment.


CONCLUSIONS
Neglect, living in squalor and hoarding are frequently symptoms of an underlying psychiatric or somatic illness. In this respect the results suggest that "standard care" proved to be of limited effect -- especially for subjects with a psychotic illness.
Wustmann
T
T
Universitätsklinik für Psychiatrie und Psychotherapie der Martin-Luther-Universität Halle-Wittenberg.
Brieger
P
P
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001927:Brain Diseases / Q000453:epidemiology* / Q000534:rehabilitation*; D003156:Community Mental Health Services / Q000706:statistics & numerical data*; D015897:Comorbidity; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D008019:Life Style; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology* / Q000534:rehabilitation*; D008875:Middle Aged; D011204:Poverty Areas; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D012923:Social Class; D016896:Treatment Outcome