S Mirisch | PubMed Health

PubMed2003

[Fugue and suicide].

The existence of dissociative fugue is doubted by many psychiatrists. We describe a 22-year-old patient who traveled about 600 km to Munich during a dissociative fugue and then exhibited an irreversible amnesia for a period of 24 h. There was a severe, clearly understandable conflict in the sense of a subjective stalemate situation which has been described as typical for dissociative fugue. The patient had a labile personality structure with insufficient coping strategies. It was possible to rule out other psychiatric or neurological disorders with sufficient certainty, and simulation was very unlikely. The conflict could not be satisfactorily solved, and the patient committed suicide 5 months later by jumping off a bridge.

Adult↗

PubMed2001

Sleep and sleep-wake cycle in an 81-year-old patient with de novo ultra-rapid cycling bipolar disorder.

This is a case report of an 81-year-old man who developed de novo bipolar disorder with ultrarapid cycling at the age of 80. Mood was self-rated daily over a period of ten weeks; in addition, polysomnographic and motor activity recordings were performed during a drug-free baseline period. Both depressive and hypomanic episodes had an average duration of about 30 hours; the affective cycle was thus independent from the sleep-wake cycle. When mood shifts occurred during nighttime, sleep was different in nights following depression than in nights following hypomania. Positron emission tomography revealed a moderate bilateral frontal hypermetabolism in the hypomanic phase and yielded normal findings for the depressive stage. In contrast to what is usually expected in ultra-rapid cycling bipolar disorder, this case demonstrates an unusual sleep-unrelated cycle duration in the oldest reported patient so far.

Aged↗