Social breakdown in the elderly, I. Case studies and management.

This report focuses on the syndrome of social breakdown of the elderly (SBE), which, although common, has attracted surprisingly little attention in clinical geropsychiatry. Profound social isolation, extreme neglect of self-care, and stubborn refusal of help are the main characteristics of SBE. In most cases, the syndrome of SBE is part of a well-defined major psychiatric illness (secondary SBE). In other cases, stressful life events cause lifelong personality abnormalities to deteriorate into full-blown syndrome of SBE (pure SBE). Two detailed case histories highlight the clinical features of pure SBE and its management.