Dissociative Fugue
What is dissociative fugue?
Dissociative fugue, formerly called psychogenic fugue, is one of a group of
conditions called dissociative disorders. The word fugue comes from the Latin
word for "flight." People with dissociative fugue temporarily lose
their sense of personal identity and impulsively wander or travel away from
their homes or places of work. People with dissociative fugue often become
confused about who they are and might even create new identities. Outwardly,
people with this disorder show no signs of illness, such as a strange appearance
or odd behavior.
Dissociative disorders are mental illnesses that involve disruptions or
breakdowns of memory, conscious awareness, identity, and/or perception. When one
or more of these functions is disrupted, symptoms can result. These symptoms can
interfere with a person’s general functioning, including social and work
activities, and relationships.
What are the symptoms of dissociative fugue?
A fugue in progress often is difficult for others to recognize because the
person’s outward behavior appears normal. Symptoms of dissociative fugue might
include the following:
- Sudden and unplanned travel away from home
- Inability to recall past events or important information from the
person’s life
- Confusion or loss of memory about his or her identity, possibly
assuming a new identity to make up for the loss
- Extreme distress and problems with daily functioning (due to the
fugue episodes)
What causes dissociative fugue?
Dissociative fugue has been linked to severe stress, which might be the
result of traumatic events—such as war, abuse, accidents, disasters, or extreme
violence—that the person has experienced or witnessed. The use or abuse of
alcohol and certain drugs also can cause fugue-like states, such as
alcohol-induced "blackouts."
How common is dissociative fugue?
Dissociative fugue is relatively rare. The frequency of dissociative fugue
tends to increase during stressful or traumatic periods, such as during wartime
or after a natural disaster.
How is dissociative fugue diagnosed?
If symptoms are present, the doctor will begin an evaluation by performing a
complete medical history and physical examination. Although there are no
laboratory tests to specifically diagnose dissociative disorders, the doctor
might use various diagnostic tests—such as X-rays and blood tests—to rule
out physical illness or medicine side effects as the cause of the symptoms.
Certain conditions—including brain diseases, head injuries, drug and alcohol
intoxication, and sleep deprivation—can lead to symptoms similar to those of dissociative disorders, including amnesia (loss of memory).
If no physical illness is found, the person might be referred to a
psychiatrist or psychologist, health care professionals who are specially
trained to diagnose and treat mental illnesses. Psychiatrists and psychologists
use specially designed interview and assessment tools to evaluate a person for a
dissociative disorder.
How is dissociative fugue treated?
The goal of treatment is to help the person come to terms with the stress or
trauma that triggered the fugue. Treatment also aims to develop new coping
methods to prevent further fugue episodes. The best treatment approach depends
on the individual and the severity of his or her symptoms, but most likely will
include some combination of the following treatment methods:
- Psychotherapy — Psychotherapy, a type of counseling, is
the main treatment for dissociative disorders. This treatment uses techniques
designed to encourage communication of conflicts and increase insight into
problems.
- Cognitive therapy — This type of therapy focuses on
changing dysfunctional thinking patterns and resulting feelings and behaviors.
- Medicine — There is no medicine to treat the dissociative disorders themselves. However, a person with a dissociative
disorder who also suffers from depression or anxiety might benefit from
treatment with a medicine such as an antidepressant or anti-anxiety medicine.
- Family therapy — This helps to teach the family about the
disorder and its causes, as well as to help family members recognize symptoms of
a recurrence.
- Creative therapies (art therapy, music therapy) — These
therapies allow the patient to explore and express his or her thoughts and
feelings in a safe and creative way.
- Clinical hypnosis — This is a treatment method that uses
intense relaxation, concentration, and focused attention to achieve an altered
state of consciousness (awareness), allowing people to explore thoughts,
feelings, and memories they might have hidden from their conscious minds. The use
of hypnosis for treating dissociative disorders is controversial due to the risk
of creating false memories.
What is the prognosis (outlook) for people with dissociative fugue?
Most fugues are brief, lasting from less than a day to several months. Often,
the disorder goes away on its own. The outlook, therefore, is quite good.
However, without treatment to work out the underlying problem, additional fugue
episodes can occur.
Can dissociative fugue be prevented?
Although it might not be possible to prevent dissociative fugue, it might be
helpful to begin treatment in people as soon as they begin to have symptoms.
Further, quick intervention following a traumatic event or emotionally
distressing experience might help reduce the risk of developing dissociative
disorders.
References
-
National Alliance on Mental Illness. Dissociative Disorders
nami.org
Accessed 4/18/2012
-
International Society for the Study of Trauma and Dissociative Disorders. Frequently Asked Questions: Dissociation and Dissociative Disorders.
www.isst-d.org
Accessed 4/18/2012
-
Mental Health America. Dissociation and Dissociative Disorders.
www.mentalhealthamerica.net
Accessed 4/18/2012
-
American Psychological Association
www.apa.org
Accessed 4/18/2012
©
Copyright 1995-2013 The Cleveland Clinic Foundation. All rights reserved
index#9790
|
