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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[1]).

Clinical Definition

The etiology of the fugue state is related to Dissociative Amnesia, (DSM-IV Codes 300.12[2]) which has several other subtypes[3]: Selective Amnesia, Generalised Amnesia, Continuous Amnesia, Systematised Amnesia, in addition to the subtype Dissociative Fugue[1].

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)[4]. It is a complex neuropsychological process[5].

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 Dissociative Fugue[1] 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 [6] 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 [6] 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.

Prevalence and onset

It has been estimated that approximately 0.2 percent of the population experiences Dissociative Fugue, although prevalence increases significantly following a stressful life event, such as wartime experience or some other disaster[6]. Other life stressors may trigger a Dissociative Fugue, such as financial difficulties, personal problems or legal issues. The causes of Dissociative Fugue are similar to those of Dissociative Amnesia and Dissociative Identity Disorder. Dissociative fugue is often mistaken for malingering, because both conditions may occur under circumstances that a person might understandably wish to evade. However, Dissociative Fugue occurs spontaneously and is not faked. Malingering is a state in which a person feigns illness because it removes him from accountability for his actions, gives him an excuse to avoid responsibilities, or reduces his exposure to a known hazard, such as a dangerous job assignment. Many fugues seem to represent a disguised wish fulfillment (for example, an escape from overwhelming stresses, such as divorce or financial ruin). Other fugues are related to feelings of rejection or separation, or they may protect the person from suicidal or homicidal impulses.

Similar to Dissociative Amnesia, the Dissociative Fugue usually affects personal memories from the past, rather than encyclopedic or abstract knowledge. A Dissociative Fugue therefore does not imply any overt seeming or "crazy" behaviour.

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[4]. Similarly, other psychological disorders may manifest symptoms similar to Dissocative Fugues. These include bipolar disorder, schizophrenia and major depressive disorder.

Treatment and prognosis

Most Dissociative Fugues last for hours or days or months, unresolved and may return. Dissociative Fugue is treated much the same as Dissociative Amnesia and Dissociative Identity Disorder, and treatment is therapy aimed at helping the person restore lost memories as soon as possible[4]. Most people who suffer Dissociative Fugues regain most or all of their prior memories; however, efforts to restore memories of the fugue period usually are unsuccessful.

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[7][8] — 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.
  • Medication — There is no medication 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 medication 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.

See also

References

External links

Identity may refer to:

Philosophy

  • Identity (philosophy), the sameness of two things
  • Identity theory of mind, in the philosophy of mind, holds that the mind is identical to the brain
  • Personal identity (philosophy)
  • Identity (social science)

..... Click the link for more information.
In psychology, memory is an organism's ability to store, retain, and subsequently retrieve information. Traditional studies of memory began in the realms of philosophy, including techniques of artificially enhancing the memory.
..... Click the link for more information.
Personality may refer to:

Psychology

  • Personality psychology, a branch of psychology which studies personality and individual differences
  • Personality development, the study of human personality development over time

..... Click the link for more information.
Etiology (alternately aetiology, aitiology) is the study of causation. Derived from the Greek αίτιολογία, "giving a reason for" (
..... Click the link for more information.
Dissociative Amnesia (formerly Psychogenic Amnesia) (DSM-IV Dissociative Disorders 300.12[1]).

Dissociative Amnesia is popularized by popular culture, particularly film, related to trauma or general psychological disorientation.
..... Click the link for more information.
Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, Text Revision, also known as DSM-IV-TR, is a manual published by the American Psychiatric Association (APA) that includes all currently recognized mental health disorders.
..... Click the link for more information.
Retrograde amnesia
Classifications and external resources

ICD-10 R 41.2
ICD-9 780.9

Retrograde amnesia is a form of amnesia where someone will be unable to recall events that occurred before the onset of amnesia.
..... Click the link for more information.
Dissociative Amnesia (formerly Psychogenic Amnesia) (DSM-IV Dissociative Disorders 300.12[1]).

Dissociative Amnesia is popularized by popular culture, particularly film, related to trauma or general psychological disorientation.
..... Click the link for more information.
Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, Text Revision, also known as DSM-IV-TR, is a manual published by the American Psychiatric Association (APA) that includes all currently recognized mental health disorders.
..... Click the link for more information.
Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, Text Revision, also known as DSM-IV-TR, is a manual published by the American Psychiatric Association (APA) that includes all currently recognized mental health disorders.
..... Click the link for more information.
Dissociation is a state of acute mental decompensation in which certain thoughts, emotions, sensations, and/or memories are compartmentalized because they are too overwhelming for the conscious mind to integrate.
..... Click the link for more information.
'The Merck Manual of Diagnosis and Therapy' (The Merck Manual or Merck's) is the world's best-selling medical textbook, now in its 18th edition.

It is recommended by librarians in standard references such as the "Brandon/Hill selected list of books and
..... Click the link for more information.
Dissociative Amnesia (formerly Psychogenic Amnesia) (DSM-IV Dissociative Disorders 300.12[1]).

Dissociative Amnesia is popularized by popular culture, particularly film, related to trauma or general psychological disorientation.
..... Click the link for more information.
Dissociative Amnesia (formerly Psychogenic Amnesia) (DSM-IV Dissociative Disorders 300.12[1]).

Dissociative Amnesia is popularized by popular culture, particularly film, related to trauma or general psychological disorientation.
..... Click the link for more information.
MeSH D009105

Dissociative Identity Disorder (DID), as defined by the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR), is a mental condition whereby a single individual evidences two or more distinct identities or
..... Click the link for more information.
Malingering
Classification & external resources

ICD-10 Z76.5
ICD-9 V65.2

Malingering is a medical and psychological term that refers to an individual fabricating or exaggerating the symptoms of mental or physical disorders for a variety of
..... Click the link for more information.
Dissociative Amnesia (formerly Psychogenic Amnesia) (DSM-IV Dissociative Disorders 300.12[1]).

Dissociative Amnesia is popularized by popular culture, particularly film, related to trauma or general psychological disorientation.
..... Click the link for more information.
MeSH D001714

Bipolar disorder is a psychiatric condition defined as recurrent episodes of significant disturbance in mood. These disturbances can occur on a spectrum that ranges from debilitating depression to unbridled mania.
..... Click the link for more information.
Schizophrenia
Classification & external resources

Eugen Bleuler (1857–1939) coined the term "Schizophrenia" in 1908
ICD-10 F 20.
ICD-9 295

OMIM 181500
DiseasesDB 11890
MedlinePlus 000928
eMedicine med/2072   emerg/520


..... Click the link for more information.
Dissociative Amnesia (formerly Psychogenic Amnesia) (DSM-IV Dissociative Disorders 300.12[1]).

Dissociative Amnesia is popularized by popular culture, particularly film, related to trauma or general psychological disorientation.
..... Click the link for more information.
MeSH D009105

Dissociative Identity Disorder (DID), as defined by the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR), is a mental condition whereby a single individual evidences two or more distinct identities or
..... Click the link for more information.
Psychotherapy is an interpersonal, relational intervention used by trained psychotherapists to aid s in problems of living. This usually includes increasing individual sense of well-being and reducing subjective discomforting experience.
..... Click the link for more information.
Cognitive Therapy (CT) is a type of psychotherapy developed by psychiatrist Aaron T. Beck in the 1960s. Becoming disillusioned with long-term psychodynamic approaches based on gaining insight into unconscious emotions and drives, Beck came to the conclusion that the way in which
..... Click the link for more information.
Psychiatric medication is a licenced psychoactive drug taken to exert an effect on the mental state and used to treat mental illness. These medications are usually made of synthetic chemical compounds, although some are naturally occurring.
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worldwide view.
Family therapy, also referred to as couple and family therapy and family systems therapy, is a branch of psychotherapy that works with families and couples in intimate relationships to nurture change and development.
..... Click the link for more information.
Art therapy is a form of expressive therapy that uses art materials, such as paints, chalk and markers. Art therapy combines traditional psychotherapeutic theories and techniques with an understanding of the psychological aspects of the creative process, especially the
..... Click the link for more information.
Music therapy is the clinical and evidence-based use of music interventions to accomplish individualized goals within a therapeutic relationship by a qualified professional who has completed an approved music therapy program.
..... Click the link for more information.
    Hypnotherapy is therapy that is undertaken with a subject in hypnosis.

    The word "hypnosis" is an abbreviation of James Braid's (1843) term "neuro-hypnotism", meaning "sleep of the nervous system".
    ..... Click the link for more information.
    The Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I) is a semistuctured interview for making most of the major DSM-IV Axis I psychiatric diagnoses. The SCID-II is a semi-structured interview for making DSM-IV Axis II (Personality Disorder) diagnoses.
    ..... Click the link for more information.
    Dissociative Disorders[1] are defined as conditions that involve disruptions or breakdowns of memory, awareness, identity and/or perception. The hypothesis is that symptoms can result, to the extent of interfering with a person's general functioning, when one or more of
    ..... Click the link for more information.


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