Fugue is defined as sudden unexpected wandering, often far from home, and an inability to remember one�s former life or identity. The person may take on an entirely new identity and a new occupation. The disorder is rare and , like psychogenic amnesia, occurs most often during wartime following natural disasters, or as result of personal crises with intense conflict.
CAUSES :
  Al though it is believed that heavy alcohol abuse may predispose an individual to the disorder, the etiology is beveled to be basically psychologial. The essential motivating factor appears to be a desire to withdraw from emotionally painful experiences. Patients with mood disorders and certain personality disorder are predisposed to fugue states.
CLINICAL FEATURES :
  There are several typical feature of psychogenic fugue. The patient wanders, in a purposeful way, usually far from home and often for days at a time. During this period, he has complete amnesia for his pas life and associations but, unlike the patients with psychogenic amnesia, he is unaware that he has forgotten anything. It is only when he suddenly returns to his former self that he recalls the time antedating the onset of the fugue, but then he remains amnesic for the period of the fugue itself. The patient in psychogenic fugue does not seem to others to be behaving in an extraordinary way, nor does he give evidence of acting out any specific memory of traumatic event. On the contrary, the fugue patient leads a quiet, prosaic, somewhat reclusive existence, works at simple occupations, lives modestly, and in general does nothing to draw attention to himself.
COURSE And PROGNOSIS :
   A fugue is usually brief hours to days. Less commonly. A fugue may last many months and involve very extensive travel covering thousands of milles. Generally, recovery is spontaneous and rapid. Reoccurrence are rare.
TREATMENT :
  Outside of supportive care no treatment is usually required. If the fugue is particularly prolonged, psychoterapy may facilitate recall of the past identity techniques such as hypnosis or amyatal interviews amy be usedful.
(Author is Consultant Psychiatrist at Raahat Hospital, Aurangabad.)