Dissociative fugue of the patient of maternity ward - A case report

• Published in: European psychiatry Vol. 26; no. S2; p. 410
• Main Authors: Załuska, M., Żurko, R., Kuroń, M., Jakiel, G., Dudel, A.
• Format: Journal Article
• Language: English
• Published: 01-03-2011
• ISSN: 0924-9338; 1778-3585
• DOI: 10.1016/S0924-9338(11)72118-6

Introduction
Mothers after childbearing are vulnerable to many stress related disorders.
Objective
to emphasize the role of the past obstetric complications, as so present infant pathology as risk factors for the mother's post partum stress related disorders.
Methods
The case analysis.
Case description
The thirty-year-old, women left the maternity ward with her baby unnoticed on the fourth day after giving birth. She was referred to psychiatry ward, after finding her by the police. In the past history the patient had spontaneous miscarriage in the first pregnancy. She has waited with her husband 6 years long for the next baby. The second pregnancy was at risk, the labor was premature and the infant has palatoschisis. The mother had difficulties with feeding. She feared about baby's life, and had feeling of being neglected by the staff. In psychiatry ward she did not reveal any symptoms of mental illness. She was interested in her child, however the period of the flight was covered with memory gap. The predominance of immature defense mechanisms, as so mild cognitive dysfunctions were revealed in psychological testing. The dissociative fugue was diagnosed. The patient was discharged without any medication to ambulatory psychotherapy.
Commentary
The interaction of past and present traumatic experiences in the patient with cognitive dysfunctions and immature defense mechanisms could impair ability of post-partum coping with fear about the child and consequently led to the loss of conscious control over the memory. Early diagnosing and supporting problematic patients of the maternity ward is needed.