Definitions

selective amnesia

Fugue state

A fugue state is a state of mind characterized by abandonment of personal identity, along with the memories, personality and other identifying characteristics of individuality. The fugue state is a condition of Dissociative Fugue (formerly Psychogenic Fugue) (DSM-IV Dissociative Disorders 300.13).

Clinical definition

The etiology of the fugue state is related to Dissociative Amnesia, (DSM-IV Codes 300.12) which has several other subtypes: Selective Amnesia, Generalised Amnesia, Continuous Amnesia, Systematised Amnesia, in addition to the subtype Dissociative Fugue.

Unlike retrograde amnesia (which is popularly referred to simply as "amnesia", the state where someone completely forgets who they are), Dissociative Amnesia is not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication, DSM-IV Codes 291.1 & 292.83) or a neurological or other general medical condition (e.g., Amnestic Disorder due to a head trauma, DSM-IV Codes 294.0). It is a complex neuropsychological process.

As the person experiencing a Dissociative Fugue may have recently suffered the reappearance of an event or person representing an earlier life trauma, the emergence of an armoring or defensive personality seems to be for some, a logical apprehension of the situation.

Therefore, the terminology fugue state may carry a slight linguistic distinction from Dissociative Fugue, the former implying a greater degree of motion. For the purposes of this article then, a fugue state would occur while one is acting out a Dissociative Fugue.

The DSM-IV defines as:

  • sudden, unexpected travel away from home or one's customary place of work, with inability to recall one's past,
  • confusion about personal identity, or the assumption of a new identity, or
  • significant distress or impairment.

The Merck Manual defines Dissociative Fugue as:

One or more episodes of amnesia in which the inability to recall some or all of one's past and either the loss of one's identity or the formation of a new identity occur with sudden, unexpected, purposeful travel away from home.

In support of this definition, the Merck Manual further defines Dissociative Amnesia as:

An inability to recall important personal information, usually of a traumatic or stressful nature, that is too extensive to be explained by normal forgetfulness.

Diagnosis

Some disorders have similar symptoms. The clinician, therefore, in his or her 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. Similarly, other psychological disorders may manifest symptoms similar to Dissocative Fugues. These include bipolar disorder, schizophrenia and major depressive disorder.

Case studies

David Fitzpatrick, a sufferer of dissociative identity disorder from the United Kingdom, was profiled on Five's television series Extraordinary People. He entered a fugue state on December 22, 2005.

See also

References

External links

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