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Living in squalor: neuropsychological function, emotional processing and squalor perception in patients found living in squalor

Published online by Cambridge University Press:  25 November 2010

Carol Gregory
Affiliation:
Greater Western Area Health Service, NSW, Australia
Graeme Halliday
Affiliation:
Concord Hospital, Sydney, Australia
John Hodges*
Affiliation:
Neuroscience Research Australia, Sydney, Australia
John Snowdon
Affiliation:
Concord Hospital and University of Sydney, Australia
*
Correspondence should be addressed to: Professor John Hodges, Neuroscience Research Australia, PO Box 1165, Randwick NSW 2031, Australia. Phone: +61 (2) 9399 1132; Fax: +61 (2) 9399 1047. Email: [email protected].
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Abstract

Background: Patients living in squalor have a wide range of psychiatric diagnoses, but these may have a common neural basis involving frontal systems. This study investigated frontal executive function, theory of mind, emotional processing including disgust, and appreciation of squalor in elderly patients found living in squalor.

Methods: Six patients referred to an old age psychiatry service underwent a battery of neuropsychological tests, assessment of living conditions and awareness of self and others’ squalor.

Results: All six patients showed impairment in frontal executive function, typically accompanied by amnesic deficits. Theory of mind and emotional processing were surprisingly preserved. While five of the patients could recognize severely unclean or cluttered living conditions in newspaper photographs, more than half did not appreciate that their own living conditions were squalid.

Conclusion: Deficits in frontal executive function appear important in the genesis of squalor although functions linked to orbito-frontal ability appear preserved.

Type
Research Article
Copyright
Copyright © International Psychogeriatric Association 2010

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