Epidemiologyĭissociative fugue is rare and, like dissociative amnesia, occurs most often during wartime, after natural disasters, and as a result of personal crisis with intense internal conflicts.According to DSM-IV–TR there is a prevalence rate of 0.2 percent in the general population. Such patients often, but not always, take on an entirely new identity is usually less complete than the alternate personalities in dissociative identity disorder,and the old and new identities do not alternate, as they do in dissociative identity disorder. Smith (who appeared to be middle-aged) to the hospital because he sustained a head wound during the physical altercation.The behavior of patient with dissociative fugue is unusual and dramatic.The term fugue is used to reflect the fact that patients physically travel away from their customary homes or work situations and fail to remember important aspects of their previous identities (name, family, occupation). Smith was brought to the emergency room after getting into a physical scuffle with another man also seeking a meal and a shower at the Salvation Army Shelter. Now that we’ve gotten through that, I’d like to get back to the shelter and get something to eat. “I’ll tell you boys once again, my name is Elvis Garfield Lancaster Smith, but my friends call me Elvis. The Case of “Elvis Garfield Lancaster Smith” The following case illustrates someone who experiences a dissociative fugue. Before making an assessment of dissociative fugue, the practitioner should also consider assessments for delirium, dementia, malingering, factitious disorder, and dissociative identity disorder. Other diagnostic categories to consider are manic or schizophrenic episodes accompanied by traveling organic, nonepileptic factors such as brain tumors and alcohol- and drug-related memory loss accompanied by wandering. The symptoms associated with dissociative fugue are the same as those for dissociative amnesia except for the sudden travel component. This orientation to the assessment helps the practitioner to discern the more serious conditions with similar symptoms (such as dissociative identity disorder Opens in new window, dementia Opens in new window, substance-related disorders, or schizophrenia Opens in new window ). The person with this disorder usually comes to the practitioner’s attention as a John or Jane Doe who is lost or confused about who he or she is and where he or she comes from.Ī competency-based assessment helps practitioners avoid being vigorous in assigning pathology and looks to strengths and coping mechanisms. Differential Assessmentĭissociative fugue is far more common in movies and television programs than in clinical practice. Once the person returns home, he or she may recall some of what happened during the fugue. The duration of the fugue state may range from a few hours to several days, and it usually ends abruptly. Symptoms rarely appear for the first time after the age of 50 but once they do appear, they usually continue well into old age (Barlow & Durand, 2012). Prevailing Patternįugue states usually do not appear until early adolescence, and more commonly occur in adulthood. In some cases, the individual assumes an entirely new identity along with traveling to another geographical location. For example, traumatic memories, financial crises, and/or marital problems have triggered fugue states. The stimulus for a fugue state usually involves the individual leaving behind some kind of difficult and troubling situation that (on some level) he or she finds intolerable. While in a fugue state, the person does not remember his or her prior life-after the fugue, the episode may or may not be remembered. Mostly, the person with this curious disorder just takes off and loses the ability to recall his or her entire previous identity.

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Fugue disorder