A rare case of dissociative fugue with unsually prolonged amnesia successfully resolved by ECT

Abstract

Case history

Young adult woman was admitted to our department with symptoms of depression. The patient had a history of sexual abuse in her childhood. After her admission she received antidepressive treatment with a selective serotonin reuptake inhibitor (sertraline) as well as supportive therapy.

Course of the disease

After a four months treatment the patient suddenly disappeared from her hometown. Some days later she was found by the police in a city hundreds of miles away. She had no memory of her previous life and identity and named herself with a new name. The patient was diagnosed as having dissociative fugue. For five months after the diagnosis was made the patient remained amnesic for her identity and autobiographical memory. No pharmaceutical medication was administered; only psychotherapy. The patient begun to have suicidal thoughts which led to her hospitalization.

Treatment

A course of electroconvulsive therapy (ECT) as well as SSRI medication (venlafaxine, initially 75mg and then 150 mg) was administered. Following the fifth course of ECT the patient recalled all of her past memory.

Conclusions:

The electroconvulsive therapy has not been shown to be an effective or appropriate treatment for dissociative disorders; some authors have indicated that it may be important in relieving an associated depression.

There are no reports on the use of ECT for dissociative fugue.

This patients paradoxal recall of memory following a course of ECT treatment forced us to this announcement.