Hostname: page-component-586b7cd67f-t7fkt Total loading time: 0 Render date: 2024-11-24T01:21:43.824Z Has data issue: false hasContentIssue false
  • English
  • Français

The Environmental Cleanliness and Clutter Scale (ECCS)

Published online by Cambridge University Press:  10 July 2009

Graeme Halliday  and
John Snowdon
Graeme Halliday
Affiliation:
Sydney South West Area Health Service, Concord Hospital, Sydney, Australia
John Snowdon*
Affiliation:
Discipline of Psychological Medicine, University of Sydney, Concord Hospital, Sydney, Australia
*
Correspondence should be addressed to: Professor John Snowdon, Discipline of Psychological Medicine, University of Sydney, Concord Hospital, N.S.W. 2139, Australia. Phone: +61-2-97675000; Fax: +61-2-97678951. Email: [email protected].
Get access Rights & Permissions [Opens in a new window]

Abstract

Background: Development of a scale to rate the degree and various aspects of uncleanliness will facilitate description and research in cases of severe domestic squalor.

Methods: Discussion with representatives of relevant agencies led to selection of various aspects of domestic uncleanliness and clutter to be assessed when describing cases of squalor. Rooms and areas with varying functions (toilet, kitchen, bedroom, etc.) were all to be rated, along with other indicators of squalor (e.g. odor, vermin). Trial use and further discussion resulted in reduction to ten items, each rated on a four-point scale, with succinct descriptions of anchor-points. Two experienced psychogeriatricians then used this new Environmental Cleanliness and Clutter Scale (ECCS) to rate independently 55 dwellings which had been reported by Aged Care staff as cluttered or unclean, and also rated overall degree of squalor. Reliability and indications of validity were analyzed.

Results: The inter-rater reliability for the ten items was considered satisfactory (κ 0.48, varying from 0.31 to 0.58). Cronbach's α for the new scale was 0.94, demonstrating high internal consistency. Each author's ratings of degree of squalor (none to severe) matched well with the other's ratings on the scale; a score of >12 usually indicated moderate or severe squalor.

Conclusion: The ECCS proved reliable and useful in rating cases where elderly people were living in severe domestic squalor.

Keywords

squalorDiogenes syndromehoardingagedhousingrating scalereliabilitymental disorder
Type
Research Article
Information
International Psychogeriatrics , Volume 21 , Issue 6 , December 2009 , pp. 1041 - 1050
Copyright
Copyright © International Psychogeriatric Association 2009

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Clark, A. N. G., Mankikar, G. D. and Gray, I. (1975). Diogenes syndrome: a clinical study of gross neglect in old age. Lancet, 1, 366–368.CrossRefGoogle ScholarPubMed
Cooney, C. and Hamid, W. (1995). Review: Diogenes syndrome. Age and Ageing, 24, 451–453.CrossRefGoogle ScholarPubMed
Cooper, J. (1970). The Leyton Obsessional Inventory. Psychological Medicine, 1, 48–64.CrossRefGoogle ScholarPubMed
Frost, R. O., Steketee, G. and Williams, L. (2000). Hoarding: a community health problem. Health and Social Care in the Community, 8, 229–234.CrossRefGoogle ScholarPubMed
Frost, R. O., Steketee, G. and Grisham, J. (2004). Measurement of compulsive hoarding: Saving Inventory-Revised. Behavior Research and Therapy, 42, 1163–1182.CrossRefGoogle ScholarPubMed
Goodman, W. K. et al. (1989). The Yale-Brown Obsessive Compulsive Scale. I. Development, use, and reliability. Archives of General Psychiatry, 46, 1006–1011.CrossRefGoogle ScholarPubMed
Halliday, G., Banerjee, S., Philpot, M. and Macdonald, A. (2000). Community study of people who live in squalor. Lancet, 355, 882–886.CrossRefGoogle ScholarPubMed
Macmillan, D. and Shaw, P. (1966). Senile breakdown in standards of personal and environmental cleanliness. British Medical Journal, 2, 1032–1037.CrossRefGoogle ScholarPubMed
Maier, T. (2004). On phenomenology and classification of hoarding: a review. Acta Psychiatrica Scandinavica, 110, 323–337.CrossRefGoogle ScholarPubMed
Pertusa, A., Fullana, M. A., Singh, S., Alonso, P., Menchon, J. M. and Mataix-Cols, D. (2008). Compulsive hoarding: OCD symptom, distinct clinical syndrome, or both? American Journal of Psychiatry, 165, 1289–1298.CrossRefGoogle ScholarPubMed
Samios, K. (1996). Into the loathsome den: the characteristics of persons living in squalor. Unpublished dissertation. Sydney: Royal Australian and New Zealand College of Psychiatrists.Google Scholar
Saxena, S. (2007). Is compulsive hoarding a genetically and neurobiologically discrete syndrome? Implications for diagnostic classification. American Journal of Psychiatry, 164, 380–384.CrossRefGoogle ScholarPubMed
Saxena, S. et al. (2002). Obsessive-compulsive hoarding: symptom severity and response to multi-modal treatment. Journal of Clinical Psychiatry, 63, 21–27.CrossRefGoogle Scholar
Snowdon, J. (1980). A comparison of written and postbox forms of the Leyton Obsessional Inventory. Psychological Medicine, 10, 165–170.CrossRefGoogle ScholarPubMed
Snowdon, J. (1987). Uncleanliness among persons seen by community health workers. Hospital and Community Psychiatry, 38, 491–494.Google ScholarPubMed
Snowdon, J. and Halliday, G. (2007). Severe domestic squalor among Sydney older persons: a study of prevalence and outcome. International Psychogeriatrics, 19 (Suppl. 1), 104.Google Scholar
Snowdon, J. and Halliday, G. (2009). How and when to intervene in cases of severe domestic squalor. International Psychogeriatrics, epublished ahead of print. doi:10.1017/S1041610209990597.CrossRefGoogle Scholar
Snowdon, J., Shah, A. and Halliday, G. (2007). Severe domestic squalor: a review. International Psychogeriatrics, 19, 37–51.CrossRefGoogle ScholarPubMed
Steketee, G. and Frost, R. (2003). Compulsive hoarding: current status of the research. Clinical Psychological Review, 23, 905–927.CrossRefGoogle ScholarPubMed
Tolin, D. F., Frost, R. O. and Steketee, G. (2007). Buried in Treasures. Help for Compulsive Acquiring, Saving and Hoarding. Oxford: Oxford University Press.Google Scholar
Wrigley, M. and Cooney, C. (1992). Diogenes syndrome – an Irish series. International Journal of Psychological Medicine, 9, 37–41.Google Scholar