“Severe domestic squalor” is not a synonym for anxiety, for depression, or for dementia; it is not a typical subject for psychiatric research in the biology of disorders. On face value, it would appear to be more suited to sociology. In the text Severe Domestic Squalor, by John Snowdon, Graeme Halliday, and Sube Banerjee, experts in this particular field, it is defined as “when a person’s home is so unclean, messy, and unhygienic, that people of similar culture and background would consider extensive clearing and cleaning to be essential” (p. 11). In this text, the authors, who are from the United Kingdom and Australia, first define the problem, logically differentiating from possibly similar-appearing disorders (e.g., hoarding). Important for practicing psychiatrists is the initial review of five series of cases of older people (conducted from 1966 to 2011), with a total of approximately 200 patients. Applicability to DSM is quite limited by both the over 40-year range of the studies and their being conducted outside of the United States. The most recent results are from a study conducted in Australia, which investigated a sample of 120 persons living in moderate or severe squalor. Using DSM-IV criteria, the most common diagnoses were dementia (35%), brain damage as a result of alcohol or substance abuse (24%), and schizophrenia or paranoid state (15%). Frequent overlap was found with hoarding (34%), of which 26% was associated with a personality disorder. These findings are similar to those of earlier studies in that no diagnosable DSM disorder was found in 13% of cases, and in some previous studies, no diagnosable disorder was found in as many as 25% of cases. It is important to realize that it cannot be simply assumed that squalor conditions come generally as a result of an individual having brain damage because the sum total rate is only 30%−60%. Piles of trash and garbage may indicate hoarding in a way that is separate from obsessive-compulsive disorder (OCD) in that this may result from individuals who “collect too much and have difficulty discarding …. Some people … have difficulty with impulse control and acquire more than they discard” (p. 32). The authors carefully differentiate between severities of squalor as well as “dry” and “wet” squalor.