P01-315 - Dissociative memory impairments and immigration

Abstract

Dissociative memory disturbances characterize dissociative disorders (such as dissociative amnesia, dissociative fugue, dissociative identity disorder, Ganser syndrome) and certain anxiety disorders (post-traumatic stress disorder). Across various cultures, they are recognized to be precipitated by psychological stress. In immigrant populations, stressful experiences arising during migration and acculturation could lead to somatic and psychiatric symptoms (including dissociative ones). A delayed onset of these symptoms - that at times occurs - may reflect a kindling sensitization or an incubation effect.ObjectivesWe review four patients who developed Dissociative Disorders (Dissociative Amnesia and Ganser Syndrome) on a background of stresses related to immigration.MethodsPatients were investigated medically, psychiatrically and neuropsychologically and in part neuroradiologically.ResultsPatients were adult males with Eastern or Central European background and no known previous psychiatric or medical illnesses. They immigrated to Germany or Canada and encountered several difficulties in the process of migration or adaptation to the new country. All developed severe psychiatric dissociative symptoms after objectively minor stresses, which occurred several years after their immigration to the new country of residence. Despite adequate treatment, their symptoms followed a chronic course. The patients’ neuropsychological profiles shared similarities, such as executive functioning deficits (e.g. limited cognitive flexibility) and impairments of emotional processing in addition to severe autobiographical amnesia.ConclusionsWe propose that stresses related to immigration and acculturation could trigger dissociative memory disorders in immigrants via a dysregulation of the hormonal stress responses, which is mediated by individual characteristics (cognitive flexibility, emotional processing abilities, language competence and cultural affiliations).