Démarche étiopathogénique face à une amnésie transitoire. À propos d’un cas

Abstract

Transitory amnesia, usually characterised as occurring brutally and being reversible, is currently considered as a dissociative disorder in the new international psychiatric classifications when no medical or neurological diseases have been identified. The dissociation is supposed to be linked to a sudden and transitory alteration of the integrative, consciousness, identity and motor functions. It is therefore essential to eliminate organic factors before searching for a psychogenic origin. The authors of the article are proposing an etiopathogenic and multidisciplinary approach of transitory amnesia based on a clinical case: after wandering for four days by train, Mr F., becoming anxious, consulted the A&E of the hospital at his partner's request. The semiological characteristics of this incident, the depressive antecedents of the patient and the absence of neurological anomaly led us to give him psychiatric care. Dissociative amnesia is usually linked to a particular event or to a psychical traumatism. Beyond this phenomenological approach and in a psychodynamic perspective, it corresponds to forgetting a specific fact and can be considered as an unconscious outward sign, that is to say a defence of the psychical economy of the patient. As far as psychiatric nosography and hysteria are concerned, the psychiatrist will have to confront the enigmatic character of the symptoms. As no standardised therapeutic consensus exists, a psychodynamic approach is useful.