What is Dissociative Amnesia?
Dissociative amnesia is a disorder, the main symptom of which is memory loss, usually for recent important events. It is not caused by an organic mental illness and is too pronounced to be explained by ordinary forgetfulness or fatigue. Amnesia usually focuses on traumatic events such as accidents or the unexpected loss of loved ones, usually it is partial and selective. Generalization and completeness of amnesia often vary from day to day and when evaluated by different researchers, but the constant common feature is the inability to remember in the waking state. Complete and generalized amnesia is rare and usually represents a manifestation of the state of the fugue.
Causes of Dissociative Amnesia
The causes of dissociative amnesia are emotional trauma, psychological conflicts. Patient destruction is a way of dealing with emotional conflict or external stress.
Symptoms of Dissociative Amnesia
Memory loss (partial) on recent, traumatic events of major importance, accompanied by confusion. Manifested in the form of several forms:
- localized amnesia – memory loss for events from a few hours to days;
- generalized amnesia – memory loss for the entire period of the disease;
- selective amnesia – for some events of the disease;
- continuous amnesia – forgetting every successive event.
The affective states that accompany amnesia are very diverse, but severe depression is rare. Confusion, distress and different degrees of behavior aimed at seeking attention may be obvious, but sometimes the position of calm reconciliation is striking.
Diagnosis of Dissociative Amnesia
For a reliable diagnosis are required:
- amnesia, partial or complete, on recent events of a traumatic or stressful nature (these aspects may become clear if there are other informants);
- lack of organic brain disorders, intoxication or excessive fatigue.
Differential diagnosis: Conducted with organic mental disorders, in which there are memory impairments (mainly memory loss to very recent events) and consistent signs of stupefaction, disorientation and fluctuations in awareness. In case of memory impairment caused by intoxication, there is an inability to recall the events that took place in the state of intoxication and the lost memory cannot be restored. Epilepsy leads to a sudden memory impairment associated with motor disorders, but it is characterized by EEG changes. In case of amnesia following CCT, memory disorders are often retrograde. Loss of short-term memory in an amnestic condition (Korsakov syndrome), when direct reproduction remains normal, but is lost after 2-3 minutes, is not detected in dissociative amnesia. Amnesia after concussion or serious brain injury is usually retrograde, although in severe cases it can be anterograde; dissociative amnesia is usually predominantly retrograde (as opposed to anterograde disorders in dissociative amnesia). Only dissociative amnesia can be modified by hypnosis. Amnesia after seizures in patients with epilepsy and in other states of stupor or mutism, sometimes found in patients with schizophrenia or depression, can usually differentiate due to other characteristics of the underlying disease.
The hardest thing to differentiate from conscious simulation, and here may require repeated and careful assessment of premorbid personality. Conscious simulation of amnesia is usually associated with obvious monetary problems, the danger of death in wartime, or the possible imprisonment or death sentence.
Treatment of Dissociative Amnesia
Psychoanalysis, hypnotherapy, narco-psychotherapy with the use of amital-caffeine disinhibition.