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A 29-year-old nun is surprised when a man states that he saw her at an exotic dancing establishment several days ago. She denies these accusations and truly has no memory of the event.
11%
6/53
A 39-year-old man presents stating that several times in the last month he felt as if he was outside of his body. He struggles to describe the experience but says the feeling best approximates "watching a movie of herself."
8%
4/53
A 21-year-old woman is reported missing by her parents in Miami. Years later it is discovered that she is living in Texas. She has no recollection of her previous life in Miami.
74%
39/53
A 25-year-old woman is brought to the emergency room by EMS when she was found naked in a clothing store. Her family and friends said that for the last 2 weeks she had been increasingly grandiose, had been sleeping 3-4 hours per night, and had not gone to work.
0%
0/53
An 82-year-old man is found several states away from his home and is not oriented to person, place, or time.
6%
3/53
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Dissociative fugue is characterized by travel without recollection of a previous life but otherwise full functionality, as described in Answer 3. A dissociative fugue state results in an abrupt change in geographic location with inability to recall the past and loss of identity. This condition is strongly associated with traumatic circumstances (e.g. disaster, war). This condition may lead to significant distress or impairment when the patient cannot recall important memories (names, addresses, ect). Kavan et al. write that dissociative symptoms may results from an acute stress disorder. The "loss of self" may also be associated with anxiety, fear and helplessness, reexperiencing the event, and avoidance behaviors. Henning-Fast et al. describe neurophysiologic data for the origins of autobiographical memory. These studies show that knowledge of self relies on "complex interactions between episodic memory contents, associated emotions and a sense of self-continuity over the course of one's life." Incorrect Answers: Answer 1: This presentation is most characteristic of dissociative identity disorder, which is distinguished from dissociative fugue by the presence of two or more distinct, alternating identities. Answer 2: This presentation is most characteristic of depersonalization disorder. Answer 4: This presentation is most characteristic of mania. Answer 5: This presentation is most characteristic of dementia.
4.7
(3)
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