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AN INDIVIDUAL PATIENT COMPARISON OF RESPONSE TO A MEMORY TRAINING PROGRAM-PSYCHOGENICVORGANIC AMNESIABrief Report1

 

作者: Shin-Ichi Izumi,   Mitsuaki Yasueda,   Nobuhiko Hihara,   Eiko Yamamoto,   Masayo Sawatari,   Akira Ishida,  

 

期刊: American Journal of Physical Medicine and Rehabilitation  (OVID Available online 1998)
卷期: Volume 77, issue 5  

页码: 458-462

 

ISSN:0894-9115

 

年代: 1998

 

出版商: OVID

 

关键词: Amnesia;Dissociative Disorders;Memory Disorders;Rehabilitation;Neoplasm;Encephalitis;Limbic System

 

数据来源: OVID

 

摘要:

Psychogenic amnesia ("dissociative amnesia" in DSM-IV) has received relatively little attention in the literature. We compared neuropsychological and behavioral findings between a patient with psychogenic amnesia and one with organic amnesia from their early stages in a rehabilitation program. A 52-yr-old man developed anterograde and retrograde amnesia and short-term memory disturbance 1 mo after an operation for esophageal carcinoma, with no loss of personal identity and information. No apparent organic causes were identified, but because the patient and his wife rejected psychiatric treatment and memory deficit characteristics were compatible with that of an organic origin, the patient was referred to a physiatrist. A 46-yr-old man with anterograde amnesia was diagnosed with limbic encephalitis based on findings of magnetic resonance imaging and single-photon emission computed tomography, which showed lesions in both medial temporal lobes. Both patients underwent "memory book" training because they showed preserved performance in motor learning tasks. The first patient's responses to training contrasted with the other's and were indicative of psychogenic amnesia, with cancer representing a precipitating stress. Counseled by the physiatrist, the patient and his wife accepted suggestions to undergo psychiatric treatment. We propose that it is important to consider behavioral responses to memory rehabilitation as well as neuropsychological findings in differentiating psychogenic amnesia from an organic one and that physiatrists may be pivotal in diagnosing and initiating treatment in such psychiatric disorders.

 



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