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Forensic Medicine · Sexual offences and forensic psychiatry: dissociative fugue
Sample itemA bank clerk is found in a distant city weeks after leaving home. He has no memory of who he is or of the journey, has been behaving normally and working there under another name. What is the likely diagnosis?
Original practice item, not a recalled exam question. Nothing here is recorded.
The answer and the reasoning
A. Dissociative fugue
Dissociative fugue is sudden purposeful travel away from home with amnesia for identity and past, and apparently normal behaviour in the interval. In a seizure automatism the episode lasts minutes with confusion, and delirium causes disorientation.
Option by option
A. Dissociative fugue (correct)
Correct. Prolonged purposeful travel with loss of identity and normal behaviour fits a fugue.
B. Complex partial seizure automatism
Seizure automatism lasts minutes, not weeks, and is not purposeful travel.
C. Malingering
Malingering needs a clear external gain, which is not described.
D. Delirium
Delirium produces clouding and disorientation, which would not allow weeks of normal work.
Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.
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