Review Question - QID 106939

This patient's clinical presentation is consistent with dissociative fugue. All three major dissociative disorders are best treated with psychotherapy.

The three major dissociative disorders are dissociative fugue, depersonalization disorder, and dissociative identity disorder. Dissociative fugue typically presents as a a person who creates a new life in a new place after a severe trauma, and has no conscious memory of their previous life. Depersonalization disorder is characterized by feelings of self-detachment, and dissociative identity disorder is characterized by 2 or more unique, alternating identities. The cornerstone of treatment for all three disorders is psychotherapy.

Lange et al. discuss the connection between post-traumatic stress disorder and dissociative disorders. They note that many patients suffer from both conditions, and treatment in such patients must address both disorders from the outset.

Brand et al. discuss the treatment of dissociative identity disorder. They note that psychotherapy for this disorder should specifically target dissociative symptoms (e.g., differences between identities, triggers for changing between identities). Psychotherapy without targeted symptom management has not been shown to be effective.

Incorrect Answers:
Answer 2: Dissociative identity disorder is more common in women than men.
Answer 3: Amnesia in dissociative fugue is often reversible; however, patients subsequently do not remember the fugue episode.
Answer 4: Depersonalization disorder is characterized by feelings of detachment from one's self.
Answer 5: Dissociative fugue should not be diagnosed if symptoms are a result of substance abuse or a general medical condition.