Dissociative Fugue

Dissociative fugue (also known as a fugue state or psychogenic fugue) is a rare psychiatric disorder with an estimated lifetime prevalence of only 0.2%. An episode of dissociative fugue often begins when an individual experiences a traumatic event such as being the victim of an assault, witnessing a violent crime, or surviving a natural disaster. Following the event, the individual is thought to dissociate from his identity and detach himself from the current surroundings in an attempt to cope with the trauma. The dissociation and detachment often draws the individual to abruptly flee to a new or unfamiliar location, experience a temporary yet reversible form of amnesia affecting his personal identity, and partially or completely adopt a new identity. Those experiencing a dissociative fugue episode often spontaneously revert from the fugue state identity to their pre-fugue identity which can lead to intense confusion and extreme distress.

Diagnosis: In many cases, dissociative fugue receives a retroactive diagnosis after an individual has spontaneously reverted from the fugue state identity to their pre-fugue identity. A physician may then review past patient history and perform a physical examination to exclude medications, illicit drug use, or a neurological condition as the cause of the reversible amnesia. A psychological examination may also be performed. Laboratory tests may be used to rule out other disorders; however, there are no specific physiological or biochemical tests used to indicate dissociative fugue.

Treatment: The goal of treatment is to help the individual cope with the event that triggered the fugue state; therefore, psychotherapy and cognitive therapy are used conjunction with psychiatric mediations. While no medication specifically treats dissociative identity disorder, it can be used curb the anxiety and depression that may result from fugue episode. In addition, creative therapies such as art or music therapy may be used to help the patient express his emotions toward the event that led to the fugue episode or those toward the fugue episode itself. Finally, hypnosis may be performed once the individual has reverted from the fugue state to the pre-fugue identity to gather information about the individual’s fugue identity and actions performed during the fugue episode. While not directly involving the treated individual, family therapy can be used to educate those close to the individual about causes of dissociative fugue and the warning signs of recurrence.

Symptoms: The primary symptoms of dissociative fugue are often a sense of confusion related to personal identity and recent activities as well as distress resulting from the sudden presence of unfamiliar locations and objects with no recollection of their significance. In addition to these symptoms, individuals suffering from dissociative fugue also abruptly travel away from home, experience reversible amnesia of personal identity, and display partial or complete adoption of a new identity.

Additional Information: Dissociative fugue episodes typically lasts less than one month; however, some cases have been known to last only hours while other cases have been reported to last decades.

Television shows such as Breaking Bad, Doctor Who, and Buffy the Vampire Slayer make reference to dissociative fugue episodes.

http://www.youtube.com/watch?v=QajubDsCcrw