dissociative fugue

WordNet

1. dissociative disorder in which a person forgets who they are and leaves home to creates a new life; during the fugue there is no memory of the former life; after recovering there is no memory for events during the dissociative state (同)psychogenic fugue
2. a dreamlike state of altered consciousness that may last for hours or days
3. a musical form consisting of a theme repeated a fifth above or a fourth below its first statement
4. a blowfish highly prized as a delicacy in Japan but highly dangerous because the skin and organs are poisonous
5. (British informal) an airless smoky smelly atmosphere
6. tending to produce dissociation

PrepTutorEJDIC

1. フーガ,遁走(とんそう)曲
2. よどんだ空気,むっとする空気,人いきれ

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2013/07/07 13:37:54」(JST)

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For the New York City-based publisher, see Fugue State Press.

Fugue state
Classification and external resources
ICD-10	F44.1
ICD-9	300.13

A fugue state, formally dissociative fugue or psychogenic fugue (DSM-IV Dissociative Disorders 300.13), is a rare psychiatric disorder characterized by reversible amnesia for personal identity, including the memories, personality and other identifying characteristics of individuality. The state is usually short-lived (ranging from hours to days), but can last months or longer. Dissociative fugue usually involves unplanned travel or wandering, and is sometimes accompanied by the establishment of a new identity.

After recovery from fugue, previous memories usually return intact, but there is typically amnesia for the fugue episode. Additionally, an episode of fugue is not characterized as attributable to a psychiatric disorder if it can be related to the ingestion of psychotropic substances, to physical trauma, to a general medical condition, or to psychiatric conditions such as delirium, dementia, bipolar disorder or depression. Fugues are usually precipitated by a stressful episode, and upon recovery there may be amnesia for the original stressor (dissociative amnesia).

Clinical definition

The etiology of the fugue state is related to dissociative amnesia, (DSM-IV Codes 300.12) which has several other subtypes: Selective Amnesia, Generalised Amnesia, Continuous Amnesia, Systematised Amnesia, in addition to the subtype Dissociative Fugue.

Unlike retrograde amnesia (which is popularly referred to simply as "amnesia", the state where someone forgets events before brain damage), dissociative amnesia is not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication, DSM-IV Codes 291.1 & 292.83) or a neurological or other general medical condition (e.g., Amnestic Disorder due to a head trauma, DSM-IV Codes 294.0). It is a complex neuropsychological process.

As the person experiencing a Dissociative Fugue may have recently suffered the reappearance of an event or person representing an earlier life trauma, the emergence of an armoring or defensive personality seems to be for some, a logical apprehension of the situation.

Therefore, the terminology fugue state may carry a slight linguistic distinction from Dissociative Fugue, the former implying a greater degree of motion. For the purposes of this article then, a fugue state would occur while one is acting out a Dissociative Fugue.

The DSM-IV defines as:

• sudden, unexpected travel away from home or one's customary place of work, with inability to recall one's past,
• confusion about personal identity, or the assumption of a new identity, or
• significant distress or impairment.

The Merck Manual defines Dissociative Fugue as:

One or more episodes of amnesia in which the inability to recall some or all of one's past and either the loss of one's identity or the formation of a new identity occur with sudden, unexpected, purposeful travel away from home.

In support of this definition, the Merck Manual further defines dissociative amnesia as:

An inability to recall important personal information, usually of a traumatic or stressful nature, that is too extensive to be explained by normal forgetfulness.

Diagnosis

A doctor may suspect dissociative fugue when people seem confused about their identity or are puzzled about their past or when confrontations challenge their new identity or absence of one. The doctor carefully reviews symptoms and does a physical examination to exclude physical disorders that may contribute to or cause memory loss. A psychologic examination is also done.

Sometimes dissociative fugue cannot be diagnosed until people abruptly return to their pre-fugue identity and are distressed to find themselves in unfamiliar circumstances. The diagnosis is usually made retroactively when a doctor reviews the history and collects information that documents the circumstances before people left home, the travel itself, and the establishment of an alternative life.

Prognosis

The DSM-IV-TR states that the fugue may have a duration from hours to months and recovery is usually rapid. However, some cases may be refractory. An individual usually only has a single episode.

Case studies

Agatha Christie disappeared on 3 December 1926 only to reappear eleven days later in a hotel in Harrogate, apparently with no memory of the events which happened during that time span.

Shirley Ardell Mason also known as "Sybil" would disappear and then reappear with no recollection of what happened during the time span. She recalls "being here and then not here" and having no identity of herself; it should be noted that it is claimed she also suffered from what was formerly called "Multiple Personality Disorder." However, Mason's diagnosis has been challenged as a hoax.

Jody Roberts, a reporter for the Tacoma News Tribune, went missing in 1985, only to be found 12 years later in Sitka, Alaska, living under the name of "Jane Dee Williams." While there were some initial suspicions that she had been faking amnesia, some experts have come to believe that she genuinely suffered a protracted fugue state.

David Fitzpatrick, a sufferer of dissociative fugue disorder, from the United Kingdom, was profiled on Five's television series Extraordinary People. He entered a fugue state on December 4, 2005, and is still working on regaining his entire life's memories.

Hannah Upp, a teacher from New York, went missing on August 28, 2008. She was rescued from the New York Harbor on September 16 with no recollection of the time in between. The episode was diagnosed as dissociative fugue.

Jeff Ingram, appeared in Denver in 2006 with no memory of his name or where he was from. After appearing on national television to appeal for help identifying himself, his fiancée Penny called Denver police identifying him. The episode was diagnosed as dissociative fugue. Jeff has experienced three incidents of amnesia: in 1994, 2006, and 2007.

In fiction

Possibly, the most profound example of extraordinarily prolonged dissociative fugue can be found in Iain Banks' the Culture series novels, where "the perfect mercenary" Cheradenine Zakalwe persists in such a state for more than a millennium, including almost one hundred lifetimes in simulated environments.

In the TV series One Tree Hill, the character Clay suffers a fugue state in season nine.

In the TV series Breaking Bad, the character Walter White fakes a fugue state to cover up his kidnapping.

In the TV series Teen Wolf, the character Lydia suffers a fugue state in season two following being bitten by a werewolf.

In the TV series Doctor Who, the character in the 2009 Christmas special, "Jackson Lake," suffers a fugue state after witnessing the death of his wife by a Cyberman attack.

In the TV series Bates Motel, the character Norman Bates suffers a fugue state episodes in which he can react violently to a stressor including attempt to kill but has no memory of it when he recovers from it.

In the TV series The Mentalist, the character Patrick Jane suffers a fugue state after nearly drowning.

In the short story The Shadow Out of Time by H.P. Lovecraft, the character Nathaniel Wingate Peaslee awakens after years of being the victim of an "identity swap" with a member of an ancient race of aliens.

In the third season of the TV series Lois and Clark: The New Adventures of Superman, Lois Lane goes into a dissociative fugue as a result of suffering a blow to the head while escaping from Lex Luthor, who had kidnapped her. Initially, in her fugue state she takes on the personality of Wanda Detroit, a fictional lounge singer from her novel. This occurs in the second episode of a five-episode plot arc; she loses the Wanda Detroit identity at the end of the third episode, but she does not fully recover her own true identity, personality, and memory until late in the fifth episode. (This arc was not popular with the audience and may have permanently damaged the show's ratings. In the teaser of an early fourth season episode, the show joked about this by having Lois hit her head on a kitchen cabinet door and then pretend to have amnesia, with Clark Kent responding, in a tone of desperate frustration, "No, no, no!", before she said to him, "Just kidding!")

Dissociative fugue affects many characters in David Lynch films with the most explicit example being the protagonist of Lost Highway.

In the year 2000 film Nurse Betty, Renée Zellweger's character Betty witnesses the murder of her husband and experiences a fugue state.

In the game Assassin's Creed 3 the character Desmond Miles experiences a fugue state upon first entering the Animus.

See also

• Structured Clinical Interview for DSM-IV
• Dissociative Disorders (DSM-IV Dissociative Disorders)
• Dissociative Identity Disorder (formerly Multiple Personality Disorder) (DSM-IV Dissociative Disorders 300.14)
• Psychogenic amnesia; Dissociative Amnesia (formerly Psychogenic Amnesia) (DSM-IV Dissociative Disorders 300.12)
• Depersonalization Disorder (DSM-IV Dissociative Disorders 300.6)
• Dissociation (psychology)

References

External links

• "Dissociative Fugue" from the Mental Health Matters website.
• "Dissociative Fugue" from the Merck & Co. website.

UpToDate Contents

全文を閲覧するには購読必要です。 To read the full text you will need to subscribe.

• 1. 解離性健忘：疫学、病因、臨床症状、経過、および診断 dissociative amnesia epidemiology pathogenesis clinical manifestations course and diagnosis
• 2. 解離性同一性障害：疫学、病因、臨床症状、経過、評価、および診断 dissociative identity disorder epidemiology pathogenesis clinical manifestations course assessment and diagnosis
• 3. 心的外傷後ストレス障害の解離性：疫学、臨床症状、評価、および診断 dissociative aspects of posttraumatic stress disorder epidemiology clinical manifestations assessment and diagnosis
• 4. 離人症性・現実感喪失性障害の治療 treatment of depersonalization derealization disorder
• 5. クライネ・レビン症候群（反復性過眠症） kleine levin syndrome recurrent hypersomnia

English Journal

• Acute panicogenic, anxiogenic and dissociative effects of carbon dioxide inhalation in patients with post-traumatic stress disorder (PTSD).

• Muhtz C, Yassouridis A, Daneshi J, Braun M, Kellner M.SourceDepartment of Psychiatry and Psychotherapy, University Hospital Hamburg-Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany.
• Journal of psychiatric research.J Psychiatr Res.2011 Jul;45(7):989-93. Epub 2011 Feb 15.
• BACKGROUND: Increased anxiety and panic to inhalation of carbon dioxide (CO(2)) has been described in patients with anxiety disorders, especially panic disorder, compared to healthy subjects. Post-traumatic stress disorder (PTSD) has been hypothesised to resemble panic disorder and is currently clas
• PMID 21324483

Japanese Journal

• 症例 全生活史健忘の1例

• 林 健司,中野 英樹,堀 輝 [他]
• 精神科 16(3), 274-281, 2010-03
• NAID 40017057175

Related Links

• Dissociative Fugue Symptoms | Psych Central

Dissociative Fugue is one or more episodes of amnesia in which the inability to recall some or all of one's past and either the loss of one's identity or the

• Dissociative fugue - causes, DSM, therapy, adults, person ...

Symptoms A person in the midst of a dissociative fugue episode may appear to have no psychiatric symptoms at all or to be only slightly confused. Therefore, for a time, it may be very difficult to spot someone experiencing ...

• Mental Health: Dissociative Fugue - WebMD - Better ...

WebMD provides information on dissociative fugue, which can be caused by extreme stress or trauma. Learn about symptoms and treatment. ... Dissociative fugue, formerly called psychogenic fugue, is one of a group of conditions ...

Related Pictures

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★リンクテーブル★

リンク元	「解離性障害」「解離性遁走」
関連記事	「fugu」

「解離性障害」

　　[★]

英

dissociative disorder, dissociative disorders

関

ヒステリー。神経症性障害、転換性障害

BBS. 133,135,135t

DSM-IV-TR

• dissociative amnesia
• dissociative fugue
• dissociative identity disorder/multiple personality disorder
• depersonalization disorder

ICD-10

• F44 Dissociative disorders 解離性障害, conversion disorders 転換性障害

概念

• 意識野の狭窄、あるいは運動系または感覚系機能障害を主症状とする神経症性障害 (PSY.201)
• 防衛機制の型により解離性障害と転換性障害にわかれる。(PSY.201)

転換性障害：葛藤やその他の心理的な問題を身体領域の症状に置き換えて(転換という防衛)現れる神経症性障害(PSY.201)

解離性障害：意識の解離(分離)を特徴とする神経症性症状(PSY.201)

解離症状

• 心因性健忘
• 遁走
• Ganser症候群
• 小児症
• 多重人格

「解離性遁走」

　　[★]

英

dissociative fugue

関

解離性障害

http://allpsych.com/disorders/dissociative/fugue.html

• 健忘症 amnesia + travel

Category

• Dissociative Disorders

Etiology

• This disorder is very rare and occurs most often during extreme stress (such as wartime or after a natural disaster).

Symptoms

• The primary feature of this disorder is abrupt travel away from home, an inability to remember important aspects of one’s life, and the partial or complete adoption of a new identity.
• The patient typically regains awareness after traveling to a different locale but retains no memory of the trip on the decision to embark on it. When they emerge from the fugue state, the patient is often confused and may be scared. (Q book p.415)

Treatment

• The disorder typically dissipates on its own and it is extremely rare to last more than one month.

Prognosis

• Prognosis is very good.

「fugu」

　　[★]

• フグ

関

Fugu rubripe、puffer fish、pufferfish、Takifugu