![]() ![]() He subsequently became involved in several religious activities to obviate his perception of impending doom. The patient had been worried that he might also fail in his final qualifying examinations scheduled to be held in 3 months. The younger brother who paid the patient’s bills had threatened to withdraw his sponsorship because of the patient’s prolonged stay in school beyond the stipulated duration of training occasioned by his repeats of examinations and classes. Prior to this episode, the patient had been under severe economic and academic pressures. The brother, however, reported that the patient appeared unkempt, looked exhausted but was fully conscious and alert on arrival at his house without any assistance. The patient denied all memory of events for the 2 days from when he left his room at the university to the time he suddenly realized he was at his brother’s house, 634km away. He equally could not remember where he slept the night he left his room, how he raised money for the journey or the buses and routes he took. The patient had no knowledge of how he made the journey that takes approximately 8 hours by road. Two days later, he discovered he was with his younger sibling in South-Western Nigeria. After this he had overwhelming fears and did not know when he left the room. He saw the whole room turning with everything inside becoming unstable and unreal. At the same time, the patient claimed he felt unease and quite uncomfortable. Ten days before presentation, while studying in his room alone at night, the patient suddenly saw a full human skeleton reading at the same table with him, sitting at the opposite side. He was later seen in a city in South-Western Nigeria, a distance of about 634km from South-Eastern Nigeria where he lived and schooled. He was declared missing for 10 days prior to presentation because his whereabouts was unknown. The patient is a 28-year old male final year medical student from the South-Eastern region of Nigeria in sub-Saharan Africa. As dissociative fugue is often comorbid with psychiatric disorders, drug treatments may be necessary for the latter. However, if the patient is still in a fugue state, the first concern is to ensure the safety and well-being of the patient. Efforts are made to reduce stressors that may precipitate another episode. , and psycho-education is given to both the patient and family. Attempts are made to elicit stressors preceding the disorder Treatment of dissociative fugue is by use of psychotherapy. ![]() Dissociative fugue can comorbid with bipolar disorder, major depressive disorder, schizophrenia, post-traumatic stress disorder, substance-related disorders, panic disorder, anxiety disorders, eating disorders and somatoform disorders It is therefore expedient that a differentiation be made between a dissociative fugue episode and dissociative fugue-like symptoms caused by a medical condition or psychological disorder. However, following recovery there is no amnesia for earlier life events before the dissociative fugue episodeĪlcohol, hallucinogens, marijuana, head trauma, brain tumors, dementia, hypertension, manic episode and schizophrenia may cause effects similar to dissociative fugue , although the fugue state may end gradually in some individuals Other factors predisposing to dissociative reactions include neuropsychological cognitive dysfunctions Dissociative fugue has also been noted to be associated with a previous history of child abuse , and often related to traumatic or stressful life events ![]() The onset is often in adolescence or early adulthood When individuals return to their pre-dissociative states, events that occurred during the fugue are not rememberedĭissociative fugue is a rare disorder and data available indicate a prevalence of 0.2% in the general population They may remain in the fugue state for a couple of days, several weeks or even months They may travel far distances during the fugue, as far as several thousand miles People with dissociative fugue temporarily lose their sense of personal identity and impulsively wander away from their homes or places of work Dissociative disorders include dissociative amnesia, fugue, depersonalization disorder, dissociative identity disorder and dissociative disorder not otherwise specified Dissociative disorders are characterized by transient or chronic failures or disruptions of integration of consciousness, memory, perception, identity or emotion. Dissociative fugue, formerly called psychogenic fugue, is one of a group of psychiatric conditions called dissociative disorders. ![]()
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