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Dissociative Amnesia ( Fugue)
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Dissociative Amnesia - formerly Psychogenic Amnesia, is a pervasive loss of memory of significant personal information. This disorder is characterized by a blocking out of critical personal information. Dissociative amnesia, unlike other types of amnesia, does not result from other medical trauma, such as a blow to the head. The predominant disturbance is one or more episodes of inability to recall important personal information, usually of a traumatic or stressful nature, that is too extensive to be explained by ordinary forgetfulness.

The disturbance does not occur exclusively during the course of Dissociative Identity Disorder, Dissociative Fugue, Post Traumatic Stress Disorder, Acute Stress Disorder, or Somatization Disorder and is not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication) or a neurological or other general medical condition (e.g., Amnestic Disorder due to a head trauma)

The symptoms cause clinically significant distress or impairment in social, occupational, or other areas of functioning. Localised amnesia: is present in a individual who has no memory of specific events that took place, usually traumatic. The loss of memory is localised within a specific window of time. For example, a survivor of a car wreck who has no memory of the experience until two days later is experiencing localised amnesia.

Dissociative amnesia has several subtypes:

Selective Amnesia: happens when a person can recall only small parts of events that took place in a defined period of time. For example, and abuse victim may recall only some parts of the series of events around his or her abuse.

Generalised Amnesia: is diagnosed when a person's amnesia encompasses this entire life.

Continuous Amnesia: occurs when the individual has no memory for events beginning from a certain point in the past continuing up to the present.

Systematised Amnesia: is characterised by a loss of memory for a specific category of
information. A person with this disorder might, for example, be missing all memories about one specific family member.

Dissociative Fugue: is a rare disorder. An individual with dissociative fugue suddenly and unexpectedly takes physical leave of his surroundings and sets off on a journey of some kind. These journeys can last hours, or even several days or months. Individuals experiencing a dissociative fugue have traveled over thousands of miles. An individual in a fugue state is unaware of or confused about his identity, and in some cases will assume a new identity (although this is the exception).Dissociative Fugue, formerly Psychogenic Fugue,- is a sudden, unplanned excursion away from ones planned itinerary accompanied by either memory loss or confusion about, loss of, or assumption of a new identity.

Associated Features:

Depression.
Anxiety Disorders.
Post Traumatic Stress Disorder.

Differential Diagnosis:

Some disorders have similar symptoms. The clinician, therefore, in his diagnostic attempt has to differentiate against the following disorders which need to be ruled out to establish a precise diagnosis.

Dementia.
Head Trauma.
Substance Intoxication.
Early symptoms of neurological disorders (eg multiple sclerosis) may resemble conversion symptoms.

Cause:

Dissociative Amnesia:

Dissociative amnesia appears to be caused by stress associated with traumatic experiences endured or witnessed, physical or sexual abuse, rape, combat, natural disasters; major life stresses, abandonment, death of a loved one, financial troubles; or tremendous internal conflict, turmoil over guilt-ridden impulses, apparently unresolvable interpersonal difficulties, criminal behaviors. Additionally, some persons are believed to be more predisposed to amnesia, eg, those who are easily hypnotized.

Dissociative Fugue:

Causes are similar to those of dissociative amnesia with some additional factors. Fugue is often thought to be malingering, because the fugue may remove the person from accountability for his actions, may absolve him of certain responsibilities, or may reduce his exposure to a hazard (such as a dangerous job assignment). Many fugues appear to represent disguised wish fulfillment. The fugue may remove the patient from an embarrassing situation or intolerable stress or may be related to issues of rejection or separation and some fugues appear to protect the person from suicidal or homicidal impulses.

Treatment:

The treatment for dissociative amnesia is therapy aimed at helping the person restore lost memories as soon as possible. If a person is not able to recall the memories, hypnosis or a medication called Pentothal (thiopental) can sometimes help to restore the memories. Psychotherapy can help an individual deal with the trauma associated with the recalled memories.

Hypnosis is often used in the treatment of dissociative fugue. Hypnosis can help the client/patient recall his/her true identity and remember the events of the past. Psychotherapy is helpful for the person who has traumatic, past events to resolve.

Counseling and Psychotherapy [ See Therapy Section ]:

Hypnotherapy [ See Hypnotherapy Section]

Pharmacotherapy [ See Psychopharmacology Section ]

 


DSM Code

300.12 Dissociative Amnesia

F44.9 Dissociative Amnesia

Disorder Sheets

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Dissociative Amnesia ( Fugue)

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Dissociative Amnesia - Fugue