He Noah's syndrome Is a pathology that affects the person in such a way that accumulates domestic animals in an obsessive way. This, of course, goes beyond affecting the person who suffers from the syndrome and affects the animals themselves, since they can not receive the minimum care and attention they require: food, water or hygienic conditions and veterinary revision. This accumulation of animals at home also causes a deterioration of the home due to lack of cleaning.
It is a disorder that is considered as a variant of the Diogenes syndrome, a behavioral disorder characterized by total personal and social neglect, as well as by voluntary isolation in one's home and accumulation in large amounts of garbage And household waste.
It is important not to confuse this syndrome, considered as a mental illness, with people who are deeply animal lovers who tend to welcome them out of compassion and are overly empathetic with the suffering of animals.
According to research reports, the most common domestic animals are cats, dogs, rabbits, birds, ferrets, guinea pigs, and even farm animals such as horses, goats, cows, sheep and chickens.
Exotic animals are also quite common, and other species of animals are sometimes more dangerous, which aggravates the situation considerably. Of all of them, cats are the most common, as much for the ease of obtaining them, their independence, their size as for their ease of attention.
It is not uncommon for cases to occur in which there are several species of animals together, although most of the time a single species is usually accumulated.
These people are characterized by an obsessive tendency to collect all the animals that are in the street to give them welcome in the house, causing this a clear deterioration in the home of the individual.
Despite the clear consequences both in the home and in the hygiene and health of the animals, affected subjects will not recognize, as in the Diogenes syndrome, that they make a mistake and that their environment is highly degraded, not even that the Animals may be suffering. A person afflicted with this disorder is far from being a true lover of their pets.
Causes of Noah's Syndrome
Typically, this syndrome usually occurs in individuals who have a Feeling of loneliness Quite high, and of any socioeconomic level. Usually, they are usually older people with no family or social networks of any kind.
The individual often believes that he is saving the life of these animals, and because of this, he continues to collect, taking home and accumulating large numbers of animals opposing them to separate from any of them, even in cases of serious animal illness. Come to give cases in which the individual refused to separate from the animal's own corpse).
At times, it may be associated with psychotic disorders, addictive disorders, neuroses, depressive disorders or personality disorders, such as bordering Or the manic-depressive.
Also in people with Noah's syndrome, age-related diseases, such as dementia , Alzheimer's or the ADHD .
The most common disorder in people affected by this syndrome is Obsessive-compulsive disorder (OCD) . The percentage of patients with OCD who were compulsively accumulating animals was, according to a study by Saxena et al., Between 18 and 40%.
At Posterior cingulate cortex Of those affected by Noah's syndrome found reduced glucose metabolism. Compared with OCD patients without compulsive hoarding (n = 33), compulsive collectors also had reduced glucose metabolism in the prefrontal dorsolateral cortex.
He Obsessive disorder It's own Perfectionists , Very demanding of themselves, who suffer anxiety attacks if they do not do what they think is right and are often overwhelmed with recurring and indomitable thoughts. Accumulation behavior would be one of the repetitive rituals they can not avoid.
On the other hand, Disorder within the spectrum of delusions and hallucinations . This is a serious psychiatric pathology that places the individual in a state out of reality, without seeing the state of the animals and the environment in which they live, denying the suffering of animals and their own discomfort. Ignoring odors, parasites, lack of hygiene, etc...
Finally, in the Affective disorders , There is an altered pattern in the relationships of affection and attachment, probably initiated in infancy. It is understood that they are people with problems in personal relationships and who have difficulties to socialize. The fact that they accumulate animals in a compulsive manner denotes a lack of social skills Where it is easier for them to relate to animals than to humans.
Consequences
The disease leads the patient to social isolation and abandonment, to such an extent that they can suffer health problems derived from the insane and neglected environment in which they live. They may even be aggressive if they try to confront the situation because they do not accept help or acknowledge their situation.
In addition to the consequences on the health of the affected ones, we must not forget the direct consequences on the animals themselves, due to lack of minimal care, medical checks, food and hygiene.
This can lead animals to Severe malnutrition Or serious diseases (parasitic infestation, dehydration or malnutrition, etc.). Animals often develop behavioral problems such as aggression or excessive fear, due to the lack of sociability and the permanent stress of living in these conditions
The researchers believe that this disorder has implications for"mental health, animal welfare and public health"and, therefore, have stated that"recognizing their presence in our society is the first step to identify and detect early cases and deal with the most Efficiently possible".
Scientists Instituto Hospital del Mar de Investigaciones Médicas (IMIM) have published in the magazine Animal Welfare The first study in Spain and one of the first in Europe that provides data on this disorder still little known and has very negative consequences both for the health of people who suffer it and for that of animals.
These data were obtained in a retrospective study in which 24 reports were obtained on various cases involving 27 people who had accumulated up to thousands of dogs and cats. Through this study, it was concluded that the majority of those affected by Noah's Syndrome were elderly or elderly people, regardless of whether they were men or women, socially isolated, with a tendency to have at home an average of 50 animals. Which belonged to a single species for a period of more than five years. These animals were in most cases in bad physical conditions (wounds, already advanced diseases and parasites among others).
This was the pioneering work that the IMIM together with animal protectors have performed on this syndrome in Europe. This has meant that they can have more direct contact with various cases of the disease and be aware of the importance involved and their frequency.
Both the IMIM and the animal protectors who had collaborated, being aware of the problem and frequency of this disease, contacted the National Association of Friends of Animals (ANAA) and decided to analyze all the cases they had collected in All those years of research which led to the creation of a questionnaire for the technicians who had participated in these investigations.
Previously, studies on the disorder in the USA, Canada and Australia had been done, however, for Europe as I mentioned earlier this study was pioneering. All this work of research produced an awareness of the importance of the frequency and with it the importance and gravity of this mental disorder also in Europe.
Treatment
At present, in most cases the corresponding municipality removes the animals but no care is given to the person who suffers. Since the person who suffers from this syndrome does not accept the problem and no action is taken, it soon ends up reoccurring.
The group of IMIM Is working with the administration to create multidisciplinary action protocols and that when a case appears, different sectors such as animal protection, public health or social welfare will be activated. This is the first work that provides data on this syndrome in Europe and has been possible thanks to the relationship of researchers with entities dedicated to the protection of animals.
In order to address this disorder from a comprehensive and multidisciplinary perspective, treatment should consist of both psychological therapy and pharmacological treatment. This treatment is usually of long duration (never less than a year), and sometimes it is necessary to maintain it for life.
The Cognitive-behavioral therapy, Emphasizing exposure (to live without those objects) and exposure with response prevention (being able to expose objects without having to collect and accumulate them), reduce anxiety, restructure dysfunctional thoughts, etc. can be quite effective.
Therapies focused on the motivation of the patient, encouraging the organization and restructuring of the disorder, assisting the therapist with housing show promising results.
Techniques in which patients can promote a demonstration of proper affection, increase their socialization and focus the person in the real situation and the environment around him, without evading, which can be very beneficial to the person.
Public veterinarians are trying to persuade those affected by talks, fines and the confiscation of their animals to change their behavior. In the US, Steketee and Frost, based on the cognitive-behavioral model of compulsive hoarding by Frost and Hartl, designed an extensive therapeutic program of 26 sessions. The treatment is about six months long and includes, in addition to the hours of therapy in the praxis or the hospital, some sessions in the patient's family environment.
Pharmacologically, the Antidepressants Of the SSRI (Selective Serotonin Reuptake Inhibitor) type have often been ineffective. In a study of Citalopram (Antidepressant and selective serotonin reuptake inhibitor) placebo-controlled, 12-week duration with 401 affected, efficacy of therapy was low. In contrast, in an open study with paroxetine (antidepressant, selective serotonin reuptake inhibitor, SSRI with anxiolytic effect) with 97 patients, therapy was successful in one-third of the patients.
To conclude, I will indicate the requirements that the Academy for the Protection of Animals has established that must be carried out to address the problem:
- Information about Noah's syndrome should be distributed among specialized circles (veterinarians, public veterinary offices, lawyers, psychologists, social workers).
- The public veterinary office must have a right of access in case of suspicion of compulsory accumulation of animals.
- A central register is required, accessible to all public veterinary offices, where information can be obtained regarding pet owners who violate the Animal Protection Law.
- More psychological and medical research is needed, especially in terms of therapy and prophylaxis.
- In order to provide assistance to humans and animals, appropriate conditions must be created for those affected to receive treatment by appropriately trained therapists.
References
- P Calvo, C Duarte, J Bowen, A Bulbena and J Fatjó. Characteristics of 24 cases of animal hoarding in Spain. Animal Welfare. Doi: 10.7120 / 09627286.23.2.199.