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OBJECTIVE: To describe a case of Post-Treatment Lyme Disease Syndrome (PTLDS) with an atypical cognitive profile. METHOD: A 41-year-old PTLDS patient underwent comprehensive neuropsychological testing and psychological assessment. RESULTS: The patient exhibited impaired intensive attention but preserved selective attention. Executive functions were normal. Short-term and anterograde memory were intact, while retrograde and semantic memory were significantly impaired. The patient also experienced identity loss, specific phobias, dissociative symptoms, and depressed mood. CONCLUSIONS: Severe episodic-autobiographical and retrograde semantic amnesia was consistent with some reports of dissociative amnesia. Loss of identity and phobias were also highly suggestive of a psychogenic mechanism underlying amnesia.

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This article discusses the possibility of practitioners who mistake organic memory loss for dissociative amnesia. It starts with the case of a young man with complete retrograde amnesia due to a traumatic head injury. Because he did not show any gross neurological abnormalities, a neurologist thought his amnesia had a psychological origin. An extensive neuropsychological examination revealed that the man did have an organic reason for his amnesia. Next, the existence of dissociative memory loss as well as isolated organic retrograde amnesia is considered. While cases of organic memory loss are well-documented, there is hardly any evidence for dissociative amnesia. It is argued that organic memory loss might be mistakenly taken for dissociative amnesia. In line with the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders, practitioners are advised to rule out the possibility of organic memory loss, before diagnosing a patient with dissociative amnesia.

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Sudden retrograde memory loss, in the absence of neurological causes, is usually referred to as a dissociative symptom. Dissociative amnesia, defined in the DSM-V as an inability to remember important autobiographical experiences, usually of a traumatic or stressful nature, is however a controversial phenomenon. Few cases with this pattern are described in the scientific literature and still fewer regarding adolescents. The objective of this study was to describe the case of an unexplained sudden memory loss that only partially fits with the criteria for dissociative amnesia, in a juvenile patient aged 16 years, which occurred during the COVID-19 lockdown. After the exclusion of any organic disturbances, 10 days after the clinical onset, a series of psychometric (neuropsychological and psychodiagnostics) tests were administered to the patient. Recent distress associated with COVID-19 lockdown was reported, while no previous significant distress or psychiatric history emerged during the clinical interview, conducted with the patient and parents. Severe disturbances in remote memory tests were registered, while no impairments in cognitive or anterograde amnestic functions were found or personality disorders. The disturbance was diagnosed as "amnesia of uncertain etiology."

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Dissociative amnesia is memory loss that cannot be explained by a neurological abnormality or typical forgetfulness. It belongs to the rare class of psychiatric ailments known as dissociative disorders. It can be accompanied with dissociative fugue where the individual travels or wanders away from home. This is a case of dissociative amnesia and dissociative fugue in a 20-year-old woman with schizoaffective disorder and post-traumatic stress disorder (PTSD). Dissociative amnesia associated with dissociative fugue is an even more rare phenomenon. This case is unique in that the patient also suffered from schizoaffective disorder and it demonstrates how dissociative disorders can be comorbid with a psychotic disorder. The amnesia itself offered antipsychotic and mood-stabilizing properties as the loss of memory eliminated her psychosis and mood instability.

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This is a case report involving a 60-year-old female who developed transient global amnesia (TGA) after an emotional psychotherapy session in the framework of post-traumatic stress disorder (PTSD). She presented to the local emergency room, three days after her psychotherapist appointment, with complaints of memory impairment. She and her husband were worried about acute stroke since it was a sudden memory loss. The patient discussed with her psychotherapist a physical assault that occurred five years ago. Three days after that discussion, the patient developed the memory loss acutely. PTSD is associated with dissociative and retrograde amnesia. This case report demonstrates that PTSD can present with anterograde amnesia in the form of TGA.

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Retrograde amnesia is described as condition which can occur after direct brain damage, but which occurs more frequently as a result of a psychiatric illness. In order to understand the amnesic condition, content-based divisions of memory are defined. The measurement of retrograde memory is discussed and the dichotomy between "organic" and "psychogenic" retrograde amnesia is questioned. Briefly, brain damage-related etiologies of retrograde amnesia are mentioned. The major portion of the review is devoted to dissociative amnesia (also named psychogenic or functional amnesia) and to the discussion of an overlap between psychogenic and "brain organic" forms of amnesia. The "inability of access hypothesis" is proposed to account for most of both the organic and psychogenic (dissociative) patients with primarily retrograde amnesia. Questions such as why recovery from retrograde amnesia can occur in retrograde (dissociative) amnesia, and why long-term new learning of episodic-autobiographic episodes is possible, are addressed. It is concluded that research on retrograde amnesia research is still in its infancy, as the neural correlates of memory storage are still unknown. It is argued that the recollection of episodic-autobiographic episodes most likely involves frontotemporal regions of the right hemisphere, a region which appears to be hypometabolic in patients with dissociative amnesia.

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Psychogenic amnesia is widely understood to be a memory impairment of psychological origin that occurs as a response to severe stress. However, there is a paucity of evidence regarding the effectiveness of psychological therapy approaches in the treatment of this disorder. The current article describes a single case, "Ben", who was treated with formulation-driven psychological therapy using techniques drawn from cognitive behavioural therapy (CBT) and acceptance and commitment therapy (ACT) for psychogenic amnesia. Before treatment, Ben exhibited isolated retrograde and anterograde memory impairments. He received 12 therapy sessions that targeted experiential avoidance followed by two review sessions, six weeks and five months later. Ben's retrograde and anterograde memory impairments improved following therapy to return to within the "average" to "superior" ranges, which were maintained at follow-up. Further experimental single case study designs and larger group studies are required to advance the understanding of the effectiveness and efficacy of psychological therapy for psychogenic amnesia.

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We report a case of psychogenic amnesia and examine the relationships between autobiographical memory impairment, the self, and ability to imagine the future. Case study JH, a 60-year-old male, experienced a 6-year period of pervasive psychogenic amnesia covering all life events from childhood to the age of 53. JH was tested during his amnesic period and again following hypnotherapy and the recovery of his memories. JH's amnesia corresponded with deficits in self-knowledge and imagining the future. Results are discussed with reference to models of self and memory and processes involving remembering and imagining.

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Remembering the past is a core feature of human beings, enabling them to maintain a sense of wholeness and identity and preparing them for the demands of the future. Forgetting operates in a dynamic neural connection with remembering, allowing the elimination of unnecessary or irrelevant information overload and decreasing interference. Stress and traumatic experiences could affect this connection, resulting in memory disturbances, such as functional amnesia. An overview of clinical, epidemiological, neuropsychological, and neurobiological aspects of functional amnesia is presented, by preponderantly resorting to own data from patients with functional amnesia. Patients were investigated medically, neuropsychologically, and neuroradiologically. A detailed report of a new case is included to illustrate the challenges posed by making an accurate differential diagnosis of functional amnesia, a condition that may encroach on the boundaries between psychiatry and neurology. Several mechanisms may play a role in "forgetting" in functional amnesia, such as retrieval impairments, consolidating defects, motivated forgetting, deficits in binding and reassembling details of the past, deficits in establishing a first person autonoetic connection with personal events, and loss of information. In a substantial number of patients, we observed a synchronization abnormality between a frontal lobe system, important for autonoetic consciousness, and a temporo-amygdalar system, important for evaluation and emotions, which provides empirical support for an underlying mechanism of dissociation (a failure of integration between cognition and emotion). This observation suggests a mnestic blockade in functional amnesia that is triggered by psychological or environmental stress and is underpinned by a stress hormone mediated synchronization abnormality during retrieval between processing of affect-laden events and fact-processing.