Metin İzzet Çağrı, Yıldırım Selman, Karahan Aykut
Faculty of Medicine, Department of Psychiatry, Karadeniz Technical University, 61080, Trabzon, Türkiye.
Faculty of Medicine, Department of Child and Adolescent Psychiatry, Karadeniz Technical University, 61080, Trabzon, Türkiye.
Ann Gen Psychiatry. 2024 Dec 19;23(1):51. doi: 10.1186/s12991-024-00536-8.
Dissociative amnesia, a disorder characterized by impairments in multiple memory areas, is frequently associated with trauma. Complex post-traumatic stress disorder (CPTSD) is marked by mood dysregulation, negative self-concept, and impaired interpersonal relationships, in addition to the classic symptoms of post-traumatic stress disorder (PTSD). The relationship between CPTSD and dissociative amnesia, as well as whether CPTSD should be considered a dissociative subtype, remains uncertain in the literature. Individuals diagnosed with CPTSD tend to exhibit higher levels of dissociative symptoms than those diagnosed with PTSD.
We present the clinical report of a 42-year-old male who, after a car accident, exhibited core symptoms of PTSD along with symptoms of self-organization disorders. While these symptoms persisted, the patient developed dissociative amnesia years after the trauma. Neuroimaging studies, psychometric tests, reviewed hospital records, and clinical interviews were conducted to speculate on the differential diagnosis of organic psychiatric conditions and potential diagnoses. The possible relationship between dissociative amnesia and complex post-traumatic stress disorder was examined.
This case demonstrates the complexity of differentiating dissociative amnesia from organic conditions. Discussing the possible shared mechanisms between CPTSD and dissociative amnesia could contribute to a better understanding of both conditions.
分离性遗忘症是一种以多个记忆区域受损为特征的疾病，常与创伤相关。复杂性创伤后应激障碍（CPTSD）除了具有创伤后应激障碍（PTSD）的典型症状外，还表现为情绪失调、消极的自我概念和人际关系受损。CPTSD与分离性遗忘症之间的关系，以及CPTSD是否应被视为一种分离性亚型，在文献中仍不确定。被诊断为CPTSD的个体往往比被诊断为PTSD的个体表现出更高水平的分离症状。
我们报告一名42岁男性的临床病例，该患者在车祸后出现了PTSD的核心症状以及自我组织障碍的症状。在这些症状持续存在的情况下，患者在创伤多年后出现了分离性遗忘症。我们进行了神经影像学研究、心理测量测试、查阅医院记录以及临床访谈，以推测器质性精神疾病的鉴别诊断和潜在诊断。我们还研究了分离性遗忘症与复杂性创伤后应激障碍之间可能的关系。
该病例表明了区分分离性遗忘症与器质性疾病的复杂性。讨论CPTSD和分离性遗忘症之间可能的共同机制有助于更好地理解这两种疾病。
