Dissociative Fugue Symptoms in a Middle-Age Hispanic Male: A Case Report

Background: Dissociative amnesia, also referred to as psychogenic amnesia, is a type of retrograde memory loss often associated with traumatic or stressful life events. While its prevalence in the medical literature is limited and it is understood to be a rare disorder with no changes noted on imaging studies, functional imaging analysis has identified impairments in a number of regions including the hippocampus, prefrontal cortex, and temporal lobe. The etiology of dissociative amnesia may include triggers such as stressful or traumatic events such as war, natural disasters, and physical assaults. Current studies reviewed indicate that disparities exist when managing distress-based amnesia when compared to those amnesias that present with organic etiologies.

Methods: A case report, as well as a review of research and literature for dissociative amnesia, was conducted.

Results: This case report describes a healthy middle-aged man who experienced retrograde autobiographical memory loss following a recent divorce and job loss. The patient presented to the emergency room after claiming to be attacked by strangers on the street. Radiographic imaging of the head revealed no acute changes. The patient suffered mostly from autobiographic memory loss, while semantic memories remained intact. During his admission to the medical unit, the patient had a suicide attempt via hanging and poor recall of the event. Management of comorbid anxiety and depression allowed progressive relearning of information. Recent history showed evidence of multiple traumatic events giving support that the main cause of dissociative amnesia and fugue state is due to psychogenic phenomena.

Conclusion: While a rare occurrence, the presence of dissociative amnesia may present with a challenging clinical course including comorbid psychiatric and organic diagnoses. Ensuring a thorough diagnostic workup is critical to prevent disparities in managing distress-based amnesias.