On the Aetiology of the Fugue States
The paper embodies the results of a study into states of compulsive wandering (fugue states ; porimania). The principal object of this study was to ascertain if these states had common aetiological features irrespective of any co-existing mental disorder. Of the 25 cases investigated, 10 were related in some way to epilepsy, 1 was a schizophrenic, and the remainder were typical manic-depressives, hysterics and psychopaths.

A feature common to the great majority of the cases was the tendency to periodical changes of mood.

Another consistent feature was represented by the disturbance of environmental conditions in childhood. The great majority of the individuals subject to compulsive wandering were found to be persons during whose development there had occurred a serious disturbance in the child-parents relationship, usually of such a nature that relationship to one or both parents was either completely lacking or only partially developed. In the majority of patients the relationship to the parent of the opposite sex was disturbed. In some the normal development of the child-parents relation had been interrupted by the absence of one of the parents from home during the patient's early years. The importance of disturbed child-parents relationship was sometimes manifested by daydreams and fantasies, in which the absent parent had a significant role. Such fantasies also occurred in connection with fugue states.

A considerable proportion of the patients exhibited as a character feature the tendency to compulsive pseudologia. In their lies the parental descent was prominent.

It has been shown that the state of compulsive wandering bears characteristics of a symbolic act.

There appear, therefore, to be three essential conditions without which fugue states do not develop: the tendency to indulge in periodic changes of mood, a disturbance of home conditions in childhood, and a tendency towards the production of twilight states, the last factor being most prominent in epileptics.

Certain types of behaviour akin to wandering states occur in children in whom there is a disturbance of home conditions similar to what has been noted in this paper.

A tendency towards rationalization and sublimation indicates in some cases the effort to oppose the irrational urge. The ultimate behaviour of the patient can often be interpreted as the result of a compromise between the opposing forces. In this case material, male patients only seemed to achieve success in this respect. In female subjects, compulsive wandering was often associated with a short period of loss of sexual control.

The biological and sociological significance of fugue states has been discussed.

Attention has been drawn to the bearing which the findings recorded in this paper have on two problems of special interest under the present war conditions; the first problem is that of the possible consequences of the break-up of the family life on children; the second problem is that of the psychological background of certain cases of desertion from military service.