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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 medication 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.

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.

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

© Copyright 1995-2012 The Cleveland Clinic Foundation. All rights reserved.

This information is provided by the Cleveland Clinic and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition. This document was last reviewed on: 3/29/2012...#9790