In conclusion, the outcome in psychogenic amnesia, particularly those characterized by fugue, is better than generally supposed. By contrast, the two focal retrograde amnesia groups showed less improvement and continued to show a reversed temporal gradient. After 3–6 months, the fugue patients had improved to normal scores for facts and near-normal scores for events. The pattern of autobiographical memory loss differed between the psychogenic groups: fugue cases showed a severe and uniform loss of memories for both facts and events across all time periods, whereas the two focal retrograde amnesia groups showed a ‘reversed’ temporal gradient with relative sparing of recent memories. However, clinical depression, family/relationship problems, financial/employment problems, and failure to recognize the family were also statistically more common in that group. As anticipated, loss of the sense of personal identity was confined to the psychogenic group. While neurological cases were characterized by relevant neurological symptoms, a history of a past head injury was actually more common in our psychogenic cases ( P = 0.012), perhaps reflecting a ‘learning episode’ predisposing to later psychological amnesia. We found that our patients with psychogenic memory loss fell into four distinct groups, which we categorized as: (i) fugue state (ii) fugue-to-focal retrograde amnesia (iii) psychogenic focal retrograde amnesia following a minor neurological episode and (iv) patients with gaps in their memories. In particular, we examined the pattern of retrograde amnesia on an assessment of autobiographical memory (the Autobiographical Memory Interview). In the present study, we reviewed the case records and neuropsychological findings in 53 psychogenic amnesia cases (ratio of 3:1, males:females), in comparison with 21 consecutively recruited neurological memory-disordered patients and 14 healthy control subjects. Consequently, the literature on psychogenic amnesia is somewhat fragmented and offers little prognostic value for individual patients. There are very few case series of patients with acute psychogenic memory loss (also known as dissociative/functional amnesia), and still fewer studies of outcome, or comparisons with neurological memory-disordered patients.
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