Skip to main content
    • Aa
    • Aa
  • Get access
    Check if you have access via personal or institutional login
  • Cited by 9
  • Cited by
    This article has been cited by the following publications. This list is generated based on data provided by CrossRef.

    Day, Mary Rose and McCarthy, Geraldine 2016. Self-Neglect: Development and Evaluation of a Self-Neglect (SN-37) Measurement Instrument. Archives of Psychiatric Nursing, Vol. 30, Issue. 4, p. 480.

    Aamodt, Whitley W. Terracina, Katherine A. and Schillerstrom, Jason E. 2015. Cognitive Profiles of Elder Adult Protective Services Clients Living in Squalor. Journal of Elder Abuse & Neglect, Vol. 27, Issue. 1, p. 65.

    Gleason, Andrew Lewis, Matthew Lee, Sook Meng and Macfarlane, Stephen 2015. A preliminary investigation of domestic squalor in people with a history of alcohol misuse: neuropsychological profile and hoarding behavior – an opportunistic observational study. International Psychogeriatrics, Vol. 27, Issue. 11, p. 1913.

    Joffe, M O'Shannessy, D Dhand, NK Westman, M and Fawcett, A 2014. Characteristics of persons convicted for offences relating to animal hoarding in New South Wales. Australian Veterinary Journal, Vol. 92, Issue. 10, p. 369.

    Lee, Sook Meng Lewis, Matthew Leighton, Deborah Harris, Ben Long, Brian and Macfarlane, Stephen 2014. Neuropsychological characteristics of people living in squalor. International Psychogeriatrics, Vol. 26, Issue. 05, p. 837.

    Rasmussen, Jessica L. Steketee, Gail Frost, Randy O. Tolin, David F. and Brown, Timothy A. 2014. Assessing Squalor in Hoarding: The Home Environment Index. Community Mental Health Journal, Vol. 50, Issue. 5, p. 591.

    Almeida, Rosa and Ribeiro, Oscar 2012. Síndrome de Diógenes: revisão sistemática da literatura. Revista Portuguesa de Saúde Pública, Vol. 30, Issue. 1, p. 89.

    Frost, Randy O. Steketee, Gail and Tolin, David F. 2012. Diagnosis and Assessment of Hoarding Disorder. Annual Review of Clinical Psychology, Vol. 8, Issue. 1, p. 219.

    Mataix-Cols, David Pertusa, Alberto and Snowdon, John 2011. Neuropsychological and neural correlates of hoarding: a practice-friendly review. Journal of Clinical Psychology, Vol. 67, Issue. 5, p. 467.


A study of severe domestic squalor: 173 cases referred to an old age psychiatry service

  • John Snowdon (a1) and Graeme Halliday (a2)
  • DOI:
  • Published online: 03 August 2010

Background: Although community psychiatric services commonly encounter cases where intervention is needed due to persons’ unclean or cluttered living conditions, evidence concerning the referral rate and prevalence of severe domestic squalor is sparse.

Methods: Between 2000 and 2009, ratings of cleanliness and clutter have been made in all cases of people living in squalor who have been referred to an old age psychiatry service in Central Sydney. Where possible, one-year follow-up was arranged.

Results: 173 persons aged 65 years or more were referred to the service during the ten years and assessed as living in squalor (120 moderate or severe, two thirds of whom showed a moderate or severe degree of hoarding/clutter). Of 157 followed up after one year, 47% were still at home, 32% were in long-term care homes, 12% had moved elsewhere, and 9% had died. The annual new referral rate was close to 1 per 1000 elderly people in the catchment area, and of moderate or severe squalor was 0.66 per 1000. Limiting follow-up to those in moderate or severe squalor, 41% were still at home one year later. Current findings suggest that the minimum prevalence in the community of older people living in moderate or severe squalor in Sydney is 1 per 1000.

Conclusions: The costs of intervening in cases of severe domestic squalor are considerable. Increased attention and funding are warranted, as the incidence and prevalence are higher than had previously been estimated.

Corresponding author
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:
Linked references
Hide All

This list contains references from the content that can be linked to their source. For a full set of references and notes please see the PDF or HTML where available.

R. O. Frost and R. C. Gross (1993). The hoarding of possessions. Behavioral Research and Therapy, 31, 367381.

R. O. Frost , G. Steketee and L. Williams (2000). Hoarding: a community health problem. Health and Community Care in the Community, 8, 229234.

J. R. Grisham , T. A. Brown , G. I. Liverant and L. Campbell-Sills (2005). The distinctiveness or compulsive hoarding from obsessive-compulsive disorder. Journal of Anxiety Disorders, 19, 767779.

G. Halliday , S. Banerjee , M. Philpot and A. Macdonald (2000). Community study of people who live in squalor. Lancet, 355, 882886.

A. C. Iervolino (2009). Prevalence and heritability of compulsive hoarding: a twin study. American Journal of Psychiatry, 166, 11561161.

H.-J. Kim , G. Steketee and R. O. Frost (2001). Hoarding by elderly people. Health and Social Work, 26, 176184. Erratum, Health and Social Work, 26, 234.

D. Macmillan and P. Shaw (1966). Senile breakdown in standards of personal and environmental cleanliness. BMJ, 2, 10321037.

T. Maier (2004). On phenomenology and classification of hoarding: a review. Acta Psychiatrica Scandinavica, 110, 323337.

S. McDermott and R. Gleeson (2009). Evaluation of the Severe Domestic Squalor Project: Final Report. Sydney: Social Welfare Research Centre, University of New South Wales.

A. Pertusa , M. A. Fullana , S. Singh , P. Alonso , J. M. Menchón and D. Mataix-Cols (2008). Compulsive hoarding: OCD symptom, distinct clinical syndrome, or both? American Journal of Psychiatry, 165, 12891298.

J. F. Samuels (2008). Prevalence and correlates of hoarding behaviour in a community-based sample. Behaviour Research and Therapy, 46, 836844.

Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

International Psychogeriatrics
  • ISSN: 1041-6102
  • EISSN: 1741-203X
  • URL: /core/journals/international-psychogeriatrics
Please enter your name
Please enter a valid email address
Who would you like to send this to? *