The principle problem is basically that luxuries aren't nearly as satisfying in the game as they are in real life. People still tend to enjoy things (as players, not characters) like collecting stuff or gambling in a computer game, since it doesn't deviate too far from the real world equivalents, but a lot of luxuries would be meaningless (consider eating "fine foods", say, though if you are really into the roleplaying it works I suppose)
One thing that Gearhead (another roguelike whose themes tended to hit into this) used was tracking the player character's "mood" in terms of a vague mixture of happiness and exhaustion, and displaying it with a series of green + marks or red - marks on the screen. When your mood is high, you get a benefit to your social / mental / manual dexterity stats and a bonus to any actions that require concentration; when it's low, you get penalties to those things.
Things like tracking through a sewer, failing at tasks, eating charred monster corpses and so on would lower your mood, while success, good food, soaking in hot springs and so forth would raise it. It felt fairly realistic -- we've all had days where a bad mood makes it hard to do something, which makes you angrier which in turn makes you do even worse until you break whatever you're trying to fix or whatever.
The ability to accumulate bonuses by having a very high mood (at least until your mood slips back towards normal) also rewarded players for luxuries and such. For instance, I'd always buy chocolate bars and carry them with me on long sewer missions.
Will adventure mode in DF ever track the player character's mood? It's such a big part of Dwarf Mode that it seems like it'd be a logical thing to extend to adventure mode although, of course, I wouldn't expect players to go insane without something Lovecraft-style causing them to. But there's various other things that could be done with it, like the bonuses / penalties I mentioned above.