Abstract
Introduction The case after exposure to intense traumatic events manifests signs and symptoms of dissociative amnesia with a dissociative fugue and schizophrenia. The psychotic symptoms we found, in this case, were very complicated and mimicking primary psychotic disorders. Therefore, this might be a good forum for the scientific world to learn from this case report, how psychotic disorders coexist with dissociative disorders, since the literatures in this area are too rare. Main Symptoms and/or Important Clinical Findings. This case report focuses on the case of dissociative amnesia with dissociative fugue and psychosis in a 25-year-old Ethiopian female who lost her husband and three children at the same time during the nearby ethnic conflict. Associated with amnesia, she lost entire autobiographical information, and she also had psychotic symptoms like delusions and auditory hallucination which is related to the traumatic event she faced. The Main Diagnoses, Therapeutic Interventions, and Outcomes. The diagnosis of dissociative amnesia with a dissociative fugue comorbid with schizophrenia was made, and both pharmacological and psychological interventions were given to the patient. After the intervention, the patient had a slight improvement regarding psychotic symptoms but her memory problem was not restored. Conclusions The observation in this case report brings to the fore that individuals with dissociative amnesia with dissociative fugue can have psychotic symptoms, and it takes a longer time to recover from memory disturbances.
Highlights
The case after exposure to intense traumatic events manifests signs and symptoms of dissociative amnesia with a dissociative fugue and schizophrenia
Posttraumatic stress disorder (PTSD) is one of the psychiatric disorder which could be a psychological reaction to such severe trauma [13] this patient had no disturbances like flashbacks, nightmares, intrusive memories of the trauma, and persistent avoidance of stimuli associated with the traumatic event; rather, she completely forgot everything related to that the traumatic event the important aspect of the traumatic event; because of this, we ruled out putting posttraumatic stress disorder as a primary diagnosis
Patients with dissociative amnesia can regain their lost memory early, and for some of them, it might take several years to recover [5, 14, 19]. At this time, it is difficult to predict whether she regains her identity and objective facts associated with her life history. This patient has suffered from long-lasting retrograde amnesia of her life with impaired self-identification which is associated with severe psychotic disturbances
Summary
Dissociation is a disruption, interruption, and/or discontinuity of the normal, subjective integration of potentially any aspect of experience and cognition, including behavior, memory, identity, consciousness, emotion, perception, body representation, and motor control which is primarily related to traumatic and/or overwhelming experiences [1]. Dissociation is a rare disorder with prevalence estimated to be 0.2% [1, 4] The onset of this disorder is usually sudden and predicated by traumatic or stressful life events like physical trauma and/or psychologically stressful events, such as natural disasters (e.g., earthquakes and floods), marital discord, physical assault, personal threats, and war or militaryrelated activities [5]. Patients with trauma-related disorders can have psychotic symptoms similar to those with a primary psychotic disorder [6, 7]. This case report shows how a psychotic. Case Reports in Psychiatry symptom presents in patients with the diagnosis of dissociative amnesia with a dissociative fugue
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