What is a Dissociative Fugue?
Dissociative fugue is characterized by loss of memory, usually on recent important events, in conjunction with externally targeted travel, during which the patient supports self-care. In some cases, a new identity is accepted, usually for several days, but sometimes for long periods and with an amazing degree of completeness. Organized travel can be in places previously known and emotionally significant. Although the period of the fugue is amnesized, the behavior of the patient at this time for independent observers may seem completely normal.
Causes of Dissociative Fugue
The main role in the development of the disorder is assigned to psychogenic factors, since the occurrence of this state is a protective mechanism for getting rid of emotionally painful experiences.
Symptoms of Dissociative Fugue
Dissociative amnesia combined with externally targeted actions, travel, often within a few days. Behavior seems completely normal. Sometimes there is a new identity. The fugue period is amnesized.
Diagnosis of Dissociative Fugue
For a reliable diagnosis should be:
- signs of dissociative amnesia;
- a purposeful journey beyond the limits of ordinary everyday life (the differentiation between travel and wandering must be carried out taking into account local specifics);
- maintenance of personal care (food, washing, etc.) and simple social interaction with strangers (for example, patients buy tickets or gasoline, ask how to drive, order food).
Differential diagnosis: Differentiation with postictal pug, which is observed mainly after temporal epilepsy, usually presents no difficulty in taking into account epilepsy in history, absence of stressful events or problems and less focused and more fragmented activity and travel in patients with epilepsy.
As with dissociative amnesia, differentiation with consciously simulating a fugue can be very difficult.
Treatment of Dissociative Fugue
Psychoanalysis, caffeine-amitic disinhibition, hypnosis.