Dissociative Fugue Causes, Symptoms, Diagnosis and Treatment

What is Dissociative Fugue?

Dissociative fugue, formerly fugue state or psychogenic fugue, is a DSM-5 Dissociative Disorder.

It is a rare psychiatric disorder characterized by reversible amnesia for personal identity, including the memories, personality, and other identifying characteristics of individuality.

The state is usually short-lived (ranging from hours to days), but can last months or longer.

Dissociative fugue usually involves unplanned travel or wandering, and is sometimes accompanied by the establishment of a new identity.

It is no longer its own classification or diagnosis as it was in the DSM-IV, but now a facet of Dissociative Amnesia according to the DSM-5.

Furthermore, after recovery from fugue, previous memories usually return intact, but there is typically amnesia for the fugue episode

Causes of Dissociative Fugue:

Dissociative fugue has been linked to severe stress, which might be the result of traumatic events that the person has experienced. Such events include:

War
Abuse
Accidents
Disasters
Extreme violence

Furthermore, the use or abuse of alcohol and certain drugs also can cause fugue-like states, such as alcohol-induced “blackouts.”

Symptoms of Dissociative Fugue:

The following symptoms may be exhibited by those suffering from dissociative fugue:

The predominant disturbance is sudden, unexpected travel away from home or one’s customary place of work, with inability to recall one’s past.

distress or impairment in social, occupational, or other important areas of functioning
Mild confusion
possible depression
Grief
shame
discomfort
Suicidal impulses
post-fugue anger

Diagnosis of Dissociative Fugue:

Dissociative fugue is diagnosed via a doctor’s evaluation.

A doctor may suspect dissociative fugue when the affected individual seem confused about his/her identity or is puzzled about his/her past or when confrontations challenge the newly assumed identity or absence of one.
The doctor carefully reviews symptoms and does a physical examination to exclude physical disorders that may contribute to or cause memory loss.
An episode of fugue is not characterized as attributable to apsychiatric disorder if it can be related to:
the ingestion ofpsychotropic substances
to physical trauma
to a general medical condition
to other psychiatric conditions such as:
dissociative identity disorder
delirium
A psychological examination is done.

Sometimes dissociative fugue cannot be diagnosed until people abruptly return to their pre-fugue identity and are distressed to find themselves in unfamiliar circumstances.

The diagnosis is usually made retroactively when a doctor reviews the history and collects information that documents the circumstances before people left home, the travel itself, and the establishment of an alternative life.