Arun SelvarajSri Manakula Vinayagar Medical College & Hospital, India
Title: Recurrent Elderly Fugue ending in Depression
Dissociative fugue is a rare disorder with a prevalence of 0.2% in the general population, mostly occurring at adolescence or early adulthood stage. Onset is usually sudden and often related to traumatic or stressful life events. Case Report: - 57years old male presented with 1 week history of sad mood, decreased interaction, increased sleep, anger outbursts with self-injurious behaviour (head banging) and suicidal thoughts. On evaluation it was found that two months back he left the home without informing others and returned on his own only 10days back. When asked about the whereabouts, he replied that he was residing in a temple premises. When family members enquired in the temple, the officials and priest over there totally denied of his presence. Moreover, he said that he stayed in temple only 4-5days and returned back home. Five years back patient had a similar episode of fugue ending in depression, when he went missing for 45 days and returned home on his own. Both the time he had stressors related to financial reason. On examination he was looking agitated with sad mood and suicidal thoughts. Brain imaging, EEG and other blood investigations came out normal. Cognitive functioning was found intact. Even after improvement on treatment patient was not able to recollect the events. Discussion: - Dissociative fugue which is commonly seen in younger age was found in an elderly man in repeated episodes. Amnesia to the event is the common feature but rarely you find confabulation. Here the patient was trying to say as if he was in the temple and returned in 4-5days which actually didn’t happen. After returning home he became severely depressed and suicidal. It is a common phenomenon that following fugue episode patient would become depressed as the fugue state which was preventing the conflicts from his conscious state would reappear.
Arun Selvaraj has completed his MD at the age of 31 years from MAHE University, Manipal. He is the Professor & Head of Psychiatry department of Sri Manakula Vinayagar Medical College & Hospital, Pondicherry University, India. He has publications in both national and international journals. He has given talk in various mental health awareness programmes. He has worked as peer reviewer in national journals.