The essential feature of dissociative amnesia is a sudden inability to recall important personal information that can't be explained by ordinary forgetfulness. The patient typically can't recall all events that occurred during a specific period, but other types of recall disturbance also are possible.
This disorder commonly occurs during war and natural disasters. Although it's more common in adolescents and young women, it also is seen in young men after combat experience. The amnesic event typically ends abruptly, and recovery is complete, with rare recurrences.
Dissociative amnesia follows severe psychosocial stress, often involving a threat of physical injury or death. Amnesia also may occur after thinking about or engaging in unacceptable behavior such as an extramarital affair.
The most common symptom of dissociative amnesia is memory loss. Shortly after becoming amnesic, a person may seem confused. Many people with dissociative amnesia are somewhat depressed or very distressed by their amnesia.
The doctor carefully reviews the person's signs and symptoms, and performs a physical examination to exclude physical causes of amnesia. Tests, including electroencephalography and blood testing for toxins and drugs, are sometimes needed to exclude physical causes. A psychologic examination is also performed. Special psychologic tests often help the doctor better characterize and understand the person's dissociative experiences to develop a treatment plan.
Psychotherapy aims to help the patient recognize the traumatic event that triggered the amnesia and the anxiety it produced. A trusting therapeutic relationship is essential to achieving this goal. The therapist subsequently attempts to teach the patient reality based coping strategies.
Strategies for the prevention of child abuse might lower the incidence of dissociative amnesia in the general population. There are no effective preventive strategies for dissociative amnesia caused by traumatic experiences in adult life in patients without a history of childhood abuse.
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