Episodes of wandering away from home is a characteristic feature of which disorder?

UPPSC 2023

Mental Health Nursing

Easy

Appeared in: UPPSC 2023

Explanation

Dissociative fugue is defined by sudden, unexpected travel away from one's home or customary place of daily activities.
This travel is accompanied by an inability to recall one's past, confusion about personal identity, or the assumption of a new identity.
The behavior is purposeful, though the individual is in a dissociated state and often trying to escape overwhelming stress or trauma.
While it is a subtype of dissociative amnesia, 'fugue' specifically describes the act of wandering or travel mentioned in the question.

Why Other Options Were Wrong

Option A: Trance & Possession disorder involves a temporary alteration in consciousness or identity, often attributed to a spiritual or external entity, but it does not have wandering as a primary characteristic.
Option B: The core feature of Dissociative Identity Disorder (DID) is the presence of two or more distinct personality states, not wandering. While fugue episodes can occur in DID, they are not its defining characteristic.
Option C: Dissociative amnesia is a broader term for memory loss that isn't due to a medical condition. While fugue involves amnesia, the term 'dissociative fugue' is more specific to the symptom of wandering.

Related Visual

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Characteristic features of dissociative disorders as background academic context rather than a clinical decision trigger.
Nurses encountering a patient in a fugue state must prioritize safety, as the person may be disoriented, vulnerable, and far from home without resources.
The primary nursing goal is to provide a safe, non-threatening environment and reorient the patient gently without forcing them to recall distressing memories, which could cause further psychological harm.
What if? If a patient presents with wandering but also has a known history of epilepsy, the nurse must consider the possibility of a complex partial seizure or postictal state, which can mimic a dissociative fugue. An EEG would be a critical diagnostic tool in this differential diagnosis.

How to Approach the Question

First, identify the key action in the question stem: 'wandering away from home'.
Next, analyze the options, which are all types of dissociative disorders. This indicates the question is testing your ability to differentiate between them.
Recall the defining characteristic of each disorder. 'Fugue' literally means 'flight' and is associated with travel or wandering.
Compare the key action ('wandering') to the definitions. Dissociative fugue is the only disorder where unexpected travel is a core, defining feature.
Eliminate other options: Trance/possession is about altered identity, DID is about multiple identities, and dissociative amnesia is a broader memory loss condition. Dissociative fugue is the most specific and accurate answer for the symptom described.

Concept Tested & Keywords

Concept Tested: Characteristic features of dissociative disorders
Stem keywords: wandering away from home, characteristic feature, disorder
Lead-in keywords: which
Clinical cues: The care setting changes urgency, monitoring level, and the expected nursing action.
Negative lead-in flag: false

Question ID

QSFD02RX_xSJragaFHrPwd

Reference Book

E6 Kaplan Sadock's Synopsis of Psychiatry-2022 (pp 1-3768 of 3768) p. 1402-1404

E6 Robert Boland, Marcia L. Verduin - Kaplan and Sadock's Comprehensive Text of Psychiatry-Wolters Kluwer Health (2024) (pp 1-16525 of 16525) pp. 6429-6431, 6491-6493

Explanation

Why Other Options Were Wrong

Related Visual

Question ID

Reference Book

More Neurotic, stress related and somatisation disorders Questions

More UPPSC 2023 Questions