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. They 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 their 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 of dissociative fugue are present, the doctor will often begin an evaluation by performing a complete medical history and physical exam. Although there are no lab tests to specifically diagnose dissociative disorders, the doctor might sometimes recommend various diagnostic tests, such as neuroimaging studies, electroencephalograms (EEGs), and blood tests, to rule out physical illness or medication side effects if these are suspected as causing the symptoms. Certain conditions -- including brain diseases (such as epilepsy), 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 interviews and assessment tools to evaluate a person for a dissociative disorder.
How Is Dissociative Fugue Treated?
The goal of dissociative fugue 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 their 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 is a specific type of psychotherapy that focuses on changing dysfunctional thinking patterns and resulting feelings and behaviors.
- Medication: There is no established medication to treat the dissociative disorders themselves. However, if a person with a dissociative disorder also suffers from depression or anxiety, they might benefit from treatment with a medication such as antidepressant, anti-anxiety, or antipsychotic drugs.
- 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 their 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 Outlook for People With Dissociative Fugue?
Most dissociative 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.