After reading Roxana’s vignette, it is apparent that she has dissociative amnesia, with possible dissociative fugue (XXXX; XXXX). Roxana symptoms that she presents in the vignette are trouble remembering events, loss of recollection of several days, inflated confidence when retroactively determined that she was in a dissociative state, followed by a markedly dazed state following coming out of the dissociative state. She also presents feelings of being “old”, cultural and familial stressors, as well as domestic abuse followed by separation with the boyfriend and a miscarriage. It is also worth noting that she has been taking Ambien periodically, which was prescribed to her mother. To meet full diagnostic criteria for dissociative amnesia, Roxana
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The diagnostic and statistical manual of mental disorders (DSM-5) (2013) proposes nine differential diagnoses to consider when considering dissociative amnesia as a diagnosis: dissociative identity disorder (DID), posttraumatic stress disorder (PTSD), neurocognitive disorders, substance-related disorders, posttraumatic amnesia due to brain injury, seizure disorder, catatonic stupor, factitious disorder and malingering, and normal and age-related changes in memory. A diagnosis of DID can be ruled out by the lack of prevalence of fluctuations in skills or knowledge, as well as the limited amount of dissociative symptoms. Furthermore, individuals with DID have two or more distinct personalities. Additional information regarding the clinicians interacting with Roxana during the time that he described her as being “more confident” would help to determine if DID should be considered as a diagnosis, instead of dissociative amnesia. With that being said, because the clinician did not report a significant shift in her personality, other than her being more confident than usual, there is reasonable grounds to assume that there are not two more distinct personalities within Roxana. A diagnosis of PTSD can be ruled out because Roxana’s amnesia does not occur when she is experiencing a traumatic event. Furthermore, she does not have problems describing or recalling stressful events, but rather she has difficulty remembering a span of several days, without an obvious acute cause for the amnesia to occur. A diagnosis of a neurocognitive disorder can be ruled out because Roxana’s intellectual and cognitive abilities seem to be intact, while only recollection of autobiographical information is affected. Further investigation into her intellectual and cognitive abilities can be pursued in order to more confidently rule out the differential diagnosis of a neurocognitive disorder. In order to rule out
The diagnostic and statistical manual of mental disorders (DSM-5) (2013) proposes nine differential diagnoses to consider when considering dissociative amnesia as a diagnosis: dissociative identity disorder (DID), posttraumatic stress disorder (PTSD), neurocognitive disorders, substance-related disorders, posttraumatic amnesia due to brain injury, seizure disorder, catatonic stupor, factitious disorder and malingering, and normal and age-related changes in memory. A diagnosis of DID can be ruled out by the lack of prevalence of fluctuations in skills or knowledge, as well as the limited amount of dissociative symptoms. Furthermore, individuals with DID have two or more distinct personalities. Additional information regarding the clinicians interacting with Roxana during the time that he described her as being “more confident” would help to determine if DID should be considered as a diagnosis, instead of dissociative amnesia. With that being said, because the clinician did not report a significant shift in her personality, other than her being more confident than usual, there is reasonable grounds to assume that there are not two more distinct personalities within Roxana. A diagnosis of PTSD can be ruled out because Roxana’s amnesia does not occur when she is experiencing a traumatic event. Furthermore, she does not have problems describing or recalling stressful events, but rather she has difficulty remembering a span of several days, without an obvious acute cause for the amnesia to occur. A diagnosis of a neurocognitive disorder can be ruled out because Roxana’s intellectual and cognitive abilities seem to be intact, while only recollection of autobiographical information is affected. Further investigation into her intellectual and cognitive abilities can be pursued in order to more confidently rule out the differential diagnosis of a neurocognitive disorder. In order to rule out