imo....I think his personal cleanliness or lack of it screams loudly of how he sees and feels about himself...worthless...so why bother. And a lot of vent up anger and rage.

His mother needs to step up to the plate a be a mother instead of ignoring her son who is obviously in distress. He should if he hasnt been to one already ... be evaluated by a psychiatrist. 5-6 visits to a psychologist isnt a bench mark for what he has or doesn't have...you or your wife need to advocate on his behalf...and get him the medical attention he needs.

Take Care