From the Research
Definition and Characteristics of Fugue State
- Dissociative fugue, formerly known as psychogenic fugue, is a rare and little understood dissociative disorder characterized by a loss of personal identity and often accompanied by a loss of memories of events (general amnesia) 1, 2.
- It is one of the least understood and yet clinically one of the most fascinating disorders in mental health 3.
- The diagnosis of dissociative fugue was first treated as a distinct psychiatric illness in Bordeaux in 1887, and was later taken up by Charcot as automatisme ambulatoire in 1888 4.
Causes and Theories
- The causes of fugue states have been attributed to various factors, including latent epilepsy and hysterical origin 4.
- Psychologic theories on the development of fugue states have also been proposed, as well as organic causes of the disorder 5.
- Significant levels of personal injury and stress have been found to precede the onset of the amnesia in some cases 2.
Clinical Presentation and Diagnosis
- Dissociative fugue is characterized by a sudden, unexpected travel away from home or work, often accompanied by a loss of memory and a partial or complete adoption of a new identity 1, 5.
- The diagnosis of dissociative fugue requires a comprehensive history, mental status examination, physical and neurological evaluation, review of previous medical and psychiatric records, and psychological testing 1.
- In some cases, associated criminal activity may allow the person with dissociative fugue to continue to function in spite of their loss of memory and original identity 1.
Treatment and Outcome
- The treatment of dissociative fugue involves an effort to reintegrate the person's identity and reunite them with their family 3.
- In some cases, the passage of time and a better emotional state may lead to improved memory test scores, but not necessarily a recovery of lost memories 2.
- The prognosis for dissociative fugue is variable, and the outcome may depend on various factors, including the underlying causes of the disorder and the effectiveness of treatment 2.