696 CHAPTER 15
CASE 15.3 • FROM THE OUTSIDE: Amnestic Disorder
A 55-year-old woman, whom we shall call Ms. A.,
... began to experience progressive diffi culties remembering. Her past medical history was
unremarkable. There was no family history of neurodegenerative disease. An example of her
problem was that she saw the same movie twice within a few days without noticing that she
had seen it the fi rst time. Despite her severe memory impairment, she lived independently
and continued managing her own shop. She was extremely aware of her predicament and
concerned about her future.
Neurological consultation was sought 3 years after the onset of her memory problem. Ele-
mentary neurological examination [and tests] were normal... her only defi cit was an amnes-
tic syndrome with amnesia [for recent events. She had a] normal attention span, preserved
memory for events that occurred before the onset of her disorder, and no confabulation or
false recognition.
Her complaints increased over the following 2 years. Examination 5 years after the onset
showed that learning of verbal and nonverbal material was severely impaired. Other cogni-
tive functions were normal.... At this time she had to give up working because of her memory
problem. She remained independent but had to use strategies, to compensate for her disor-
der. She continued traveling by herself. On one occasion she left her suitcase at one hotel and,
not remembering where she had left it, slept at another hotel.
During the following years her memory problems remained unchanged and she was very
conscious of her defi cit.... Formal assessment of memory, 13 years after her initial complaint,
revealed no additional change in her performance.... No behavioral change was observed
and she remained alert and well groomed. She was fully aware of her predicament and con-
tinued caring for herself.
(Didic et al., 1998, pp. 526–527)
Prevalence- The prevalence of amnestic disorder is unknown.
Comorbidity - Substance-related disorders may contribute to amnestic disorder in some cases.
Onset - The age of onset varies, depending on the cause of the memory problems.
- Symptoms may emerge rapidly or gradually, depending on the cause of the memory problems.
- Prior to the emergence of the memory problems, the person may be confused or disoriented
and have attentional problems, which may lead to a diagnosis of delirium.
Course - Depending on the cause of the memory problems, symptoms may last anywhere from a few
hours to indefi nitely. - When the disorder is due to head trauma, symptoms improve the most within the fi rst few
months, and may continue to improve for up to 2 years after the trauma. - When memory problems begin, the person may confabulate; as the problems persist, the
person usually confabulates less or not at all. - People may deny that they have memory problems, even when presented with “proof ”; they
may, in turn, accuse others of manufacturing the “proof.”
Gender Differences - Given the lack of research on the prevalence of this disorder, it is unknown whether a sex dif-
ference exists.
Source: American Psychiatric Association, 2000.
Table 15.5 • Amnestic Disorder Facts at a Glance