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Amnesia

Organic and Psychogenic

Published online by Cambridge University Press:  02 January 2018

M. D. Kopelman*
Affiliation:
Institute of Psychiatry, De Crespigny Park, Denmark Hill, London SE5 8AF, UK

Abstract

This paper describes the clinical features of selected examples of organic and psychogenic amnesia, and it discusses the nature of the dysfunction that these amnesias entail. The anterograde component of organic amnesia involves a severe impairment in acquiring (or learning) new information, rather than accelerated forgetting, and this may reflect an underlying limbic or neurochemical dysfunction. Retrograde amnesia has a basis which is (at least partially) independent of anterograde amnesia - in some patients, it appears to involve a failure to reconstruct past experience from contextual cues, and this may reflect a superimposed frontal dysfunction. Two types of confabulation are discussed, one of which (‘provoked’) is a normal response to poor memory, and the other ('spontaneous’) appears to reflect incoherent, context-free retrieval, associated with more severe frontal pathology. It is argued that many cases of psychogenic amnesia may resemble organic amnesia, in that they result from an impaired acquisition of information at the time of initial input, perhaps thereby predisposing the subject to subsequent retrieval difficulties.

Type
Review Article
Copyright
Copyright © 1987 The Royal College of Psychiatrists 

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References

Abeles, M. & Schilder, P. (1935) Psychogenic loss of personal identity. Archives of Neurology and Psychiatry, 34, 587604.Google Scholar
Arendt, T., Bigl, V., Arendt, A. & Tennstedt, A. (1983) Loss of neurons in the nucleus basalis of Meynert in Alzheimer's diseases, Paralysis Agitans and Korsakoff's disease. Acta Neuropathologica (Berlin), 61, 101108.CrossRefGoogle ScholarPubMed
Baddeley, A. D. (1982) Domains of recollection. Psychological Review, 89, 708729.Google Scholar
Baddeley, A. D., Harris, J. E., Sunderland, A., Watts, K. & Wilson, B. (1987) Closed head injury and memory. In Neurobehavioral Recovery from Head Injury (ed. H. Levin). Oxford University Press.Google Scholar
Baddeley, A. D. & Wilson, B. (1986) Amnesia, autiobiographical memory and confabulation. In Autobiographical Memory (ed. D. Rubin). Cambridge: Cambridge University Press.Google Scholar
Bartlett, F. (1932) Remembering. London: Cambridge University Press.Google Scholar
Berlyne, N. (1972) Confabulation. British Journal of Psychiatry, 120, 3139.Google Scholar
Berrington, W. P., Liddell, D. W. & Foulds, G. A. (1956) A réévaluation of the fugue. Journal of Mental Science, 102, 281286.Google Scholar
Blass, J. P. & Gibson, G. E. (1977) Abnormality of a thiamine-requiring enzyme in patients with Wernicke-Korsakoff syndrome. New England Journal of Medicine, 297, 13671370.CrossRefGoogle ScholarPubMed
Bower, G. H. (1981) Mood and memory. American Psychologist, 36, 129148.Google Scholar
Bradford, J. & Smith, S. M. (1979) Amnesia and homicide: the Padola case and a study of thirty cases. Bulletin of the American Academy of Psychiatry and the Law, 7, 219231.Google Scholar
Brooks, N. (1984) Cognitive deficits after head injury. In Closed Head Injury Psychological, Social and Family Consequences (ed. N. Brooks) Oxford: Oxford University Press.Google Scholar
Brooks, N. (1972) Memory and closed head injury. Journal of Nervous and Mental Disease, 155, 350355.Google Scholar
Butters, N. & Albert, M. (1982) Remote memory, retrograde amnesia, and the neuropsychology of memory. In Human Memory and Amnesia (ed. L. S. Cermak). Hillsdale, NJ: Lawrence Erlbaum.Google Scholar
Carr, A. C. (1982) Memory deficit after fornix section. Neuropsychologia, 20, 9598.CrossRefGoogle ScholarPubMed
Claparede, E. (1911) Recognition and ‘me-ness’. (Recognition et moiite) Archives Psychologique, Geneve, 11, 7990.Google Scholar
Clark, D. M. & Teasdale, J. D. (1982) Diurnal variation in clinical depression and accessibility of memories of positive and negative experiences. Journal of Abnormal Psychology, 91, 8795.Google Scholar
Cohen, R. M., Weingartner, H., Smallberg, S. A., Pickar, D. & Murphy, D. L. (1982) Effort and cognition in depression. Archives of General Psychiatry, 39, 593597.Google Scholar
Coriat, LH. (1907) The Lowell case of amnesia. Journal of Abnormal Psychology, 2, 93111.CrossRefGoogle Scholar
Cutting, J. (1978a) Relationship between Korsakoff's syndrome and “alcoholic dementia'∗. British Journal of Psychiatry, 132, 240251.CrossRefGoogle Scholar
Cutting, J. (1978b) A cognitive approach to Korsakoff's syndrome. Cortex, 14, 485495.Google Scholar
De Wardener, H. E. & Lennox, B. (1947) Cerebral beriberi (Wernicke's encephalopathy): review of 52 cases in a Singapore P.O.W. hospital. Lancet, i, 1117.CrossRefGoogle Scholar
Erdelyi, M. H., Goldberg, B. (1979) Let's not sweep repression under the rug: toward a cognitive psychology of repression. In Functional Disorders of Memory (eds J. F. Kihlstrom & F. J. Evans). Hillsdale, NJ: Lawrence Erlbaum.Google Scholar
Freeman, C. P. L., Weeks, D. & Kendell, R. E. (1980) Electroconvulsive therapy. British Journal of Psychiatry, 137, 837.Google Scholar
Freud, S. (1915/17) Introductory Lectures. Harmondsworth: Penguin.Google Scholar
Frith, C. D., Stevens, M., Johnstone, E. C., Deakin, J. F. W., Lawler, P. & Crow, T. J. (1983) Effects of ECT and depression on various aspects of memory. British Journal of Psychiatry, 142, 610617.Google Scholar
Gillespie, R. D. (1937) Amnesia. Archives of Neurology and Psychiatry, 37, 748764. Goldberg, E., Hughes, J. E. O.,CrossRefGoogle Scholar
Mattis, S. & Antin, S. P. (1982) Isolated retrograde amnesia: different aetiologies, same mechanisms? Cortex, 18, 459462.Google Scholar
Goodwin, D. W., Crane, J. B. & Guze, S. B. (1969) Phenomenological aspects of the alcoholic ‘blackout’. British Journal of Psychiatry, 115, 10331038.Google Scholar
Gudjonsson, G. H. & Taylor, P. J. (1985) Cognitive deficit in a case of retrograde amnesia. British Journal of Psychiatry, 147, 715718.CrossRefGoogle Scholar
Guttmacher, M. S. (1955) Psychiatry and the Law. New York: Grune & Stratton.Google Scholar
Harper, C. (1983) The incidence of Wernicke's encephalopathy in Australia: a neuropathological study of 131 cases. Journal of Neurology, Neurosurgery and Psychiatry, 46, 593598.CrossRefGoogle Scholar
Hierons, R., Janota, I. & Corsellis, J. A. N. (1978) The late effects of necrotizing encephalitis of the temporal lobes and limbic areas: a clinico-pathological study of 10 cases. Psychological Medicine, 8, 2142.Google Scholar
Hollander, E., Mohs, R. C. & Davis, K. L. (1986) Cholinergic approaches to the treatment of Alzheimer's disease. British Medical Bulletin, 42, 97100.Google Scholar
Hopwood, J. S. & Snell, H. K. (1933) Amnesia in relation to crime. Journal of Mental Science, 79, 2741.Google Scholar
Huppert, F. A. & Piercy, M. (1976) Recognition memory in amnesic patients: effect of temporal context and familiarity of material. Cortex, 12, 320.Google Scholar
Huppert, F. A. & Piercy, M. (1978) Dissociation between learning and remembering in organic amnesia. Nature, 275, 317318.CrossRefGoogle ScholarPubMed
Huppert, F. A. & Piercy, M. (1979) Normal and abnormal forgetting in organic amnesia: effect of locus of lesion. Cortex, 15, 385390.Google Scholar
Huppert, F. A. & Kopelman, M. D. (1987) Rate of forgetting in normal ageing: a comparison with dementia. Submitted for publication. James, W. (1890) Principles of Psychology, Vol. 1. New York: Holt.Google Scholar
Janis, I. L. & Astrachan, M. (1951) The effects of electroconvulsive treatments on memory efficiency. Journal of Abnormal and Social Psychology, 46, 501511.CrossRefGoogle ScholarPubMed
Johnson, M. K., Kim, J. K. & Risse, G. (1985) Do alcoholic KorsakofPs syndrome patients acquire affective reactions? Journal of Experimental Psychology, Language, Memory, Cognition, 11, 2236.Google Scholar
Kanzer, M. (1939) Amnesia: a statistical study. American Journal of Psychiatry, 96, 711716.Google Scholar
Kapur, N. & Coughlan, A. K. (1980) Confabulation and frontal lobe dysfunction. Journal of Neurology, Neurosurgery and Psychiatry, 43, 461463.Google Scholar
Kapur, N., Heath, P., Meudell, P. & Kennedy, P. (1986) Amnesia can facilitate memory performance: evidence from a patient with dissociated retrograde amnesia. Neuropsychologia, 24, 215222.Google Scholar
Kennedy, A. & Neville, J. (1957) Sudden loss of memory. British Medical Journal, ii, 428433.Google Scholar
Kopelman, M. D. (1982) Speech dominance, handedness and electro-convulsions. Psychological Medicine, 12, 667670.Google Scholar
Kopelman, M. D. (1985a) Multiple memory deficits in Alzheimer-type dementia: implications for pharmacotherapy. Psychological Medicine, 15, 527541.Google Scholar
Kopelman, M. D. (1985b) Rates of forgetting in Alzheimer-type dementia and Korsakoff's syndrome. Neuropsychologia, 23, 623638.CrossRefGoogle ScholarPubMed
Kopelman, M. D. (1986a) Clinical tests of memory. British Journal of Psychiatry, 148, 517525.Google Scholar
Kopelman, M. D. (1986b) Recall of anomalous sentences in dementia and amnesia. Brain and Language, 29, 154170.Google Scholar
Kopelman, M. D. (1986c) The cholinergic neurotransmitter system in human memory and dementia: a review. Quarterly Journal of Experimental Psychology, 38A, 535573.CrossRefGoogle Scholar
Kopelman, M. D. & Lishman, W. A. (1986) Pharmacological treatments of dementia (non-cholinergic). British Medical Bulletin, 42, 101105.Google Scholar
Korsakoff, S. S. (1889) Psychic disorder in conjunction with peripheral neuritis. Translated and republished (1955) by Victor, M. and Yakovlev, P. I., Neurology, 5, 394406.Google Scholar
Lawson, R. (1879) On the symptomatology of alcoholic brain disorders. Brain, 1, 182194.Google Scholar
Leigh, D., McBurney, A. & McIlwain, H. (1981) Erythrocyte transketolase activity in the Wernicke-Korsakoff syndrome. British Journal of Psychiatry, 139, 153156.Google Scholar
Le itch, A. (1948) Notes on amnesia in crime for the general practitioner. Medical Press, 219, 459463.Google Scholar
Lishman, W. A. (1968) Brain damage in relation to psychiatric disability after head injury. British Journal of Psychiatry, 114, 373410.Google Scholar
Lishman, W. A. (1972) Selective factors in memory, 2: affective disorder. Psychological Medicine, 2, 248253.Google Scholar
Lishman, W. A. (1987) Organic Psychiatry: the psychological consequences of cerebral disorder. 2nd ed. Oxford: Blackwell Scientific. (In press).Google Scholar
Lloyd, G. C. & Lishman, W. A. (1975) Effect of depression on the speed of recall of pleasant and unpleasant experience. Psychological Medicine, 5, 173180.Google Scholar
Luria, A. R. (1969) The Mind of a Mnemonist. London: Jonathan Cape.Google Scholar
Luria, A. R. (1976) The Neuropsychology of Memory. New York: John Wiley.Google Scholar
Lynch, S. & Yarnell, P. R. (1973) Retrograde amnesia: delayed forgetting after concussion. American Journal of Psychology, 86, 643645.Google Scholar
Majr, W. G. P., Warrington, E. K. & Weiskrantz, L. (1979) Memory disorder in Korsakoff's psychosis: a neuropathological and neuropsychological investigation of two cases. Brain, 102, 749783.Google Scholar
Malamud, N. & Skillicorn, S. A. (1956) Relationship between the Wernicke and Korsakoff syndrome. Archives of Neurological Psychiatry, 76, 585596.Google Scholar
Markowitsch, H.J. (1984) Can amnesia be caused by damage of a single brain structure? Cortex, 20, 2745.Google Scholar
Martin, P. R., Weingartner, H., Gordon, E. K., Burns, R. S., Linnoila, M., Kopin, I. J., Ebert, M. H. (1984) Central nervous system catecholamine metabolism in Korsakoff's psychosis. Annals of Neurology, 15, 184187.Google Scholar
Master, D., Lishman, W. A. & Smith, A. (1983) Speed of recall in relation to affective tone and intensity of experience. Psychological Medicine, 13, 325331.Google Scholar
Mayes, A. R., Meudell, P. R. & Pickering, A. (1985) Is organic amnesia caused by a selective deficit in remembering contextual information? Cortex, 21, 167202.Google Scholar
McDowall, J. (1981) Effects of encoding instructions on recall and recognition in Korsakoff patients. Neuropsychologia, 19, 4348.Google Scholar
McEntee, W. J., Biber, M. P., Perl, D. P. & Benson, D. F. (1976) Diencephalic amnesia: a reappraisal. Journal of Neurology, Neurosurgery and Psychiatry, 39 436441.Google Scholar
McEntee, W. J., Mair, R. G. & Langlais, P. J. (1984) Neurochemical pathology in Korsakoff's psychosis: implications for other cognitive disorders. Neurology, 34, 648652.Google Scholar
Meltzer, H. (1930) Individual differences in forgetting pleasant and unpleasant experience. Journal of Educational Psychology, 21, 399409.Google Scholar
Merskey, H. & Woodforde, J. M. (1972) Psychiatric sequelae of minor head injury. Brain, 95, 521528.CrossRefGoogle ScholarPubMed
Meudell, P. R., Mayes, A. R. & Neary, D. (1979) Is amnesia caused by a consolidation impairment? In Research in Psychology and Medicine (eds D. J. Osborne, M. M. Gruneberg & J. R. Eiser). London: Academic Press.Google Scholar
Miller, E. (1973) Short- and long-term memory in patients with presenile dementia (Alzheimer's disease). Psychological Medicine, 3, 321324.Google Scholar
Milner, B. (1966) Amnesia following operation on the temporal lobes. In Amnesia (eds C. W. M. Witty & O. Zangwill). London: Butter worth.Google Scholar
Mishkin, M. (1978) Memory in monkeys is severely impaired by combined but not by separate removal of amygdala and hippocampus. Nature, 273, 297298.Google Scholar
Moll, J. M. (1916) The amnesia of Korsakoff's syndrome with alcoholic aetiology: an analysis of 30 cases. Journal of Mental Science, 61, 423437.Google Scholar
Morris, R. G. & Kopelman, M. D. (1986) The memory deficits in Alzheimer-type dementia: a review. Quarterly Journal of Experimental Psychology, 38A, 575602.Google Scholar
Moscovitch, M. (1982) Multiple dissociations of function in amnesia. In Human Memory and Amnesia (ed. L. S. Cermak). Hillsdale, NJ: Lawrence Erlbaum.Google Scholar
O'Connell, B. A. (1960) Amnesia and homicide. British Journal of Delinquency, 10, 262276.Google Scholar
Owen, M. J. & Butler, S. R. (1981) Amnesia after transection of the fornix in monkeys: long-term memory impaired, short-term memory intact. Behavioural Brain Research, 3, 115123.Google Scholar
Parfitt, D. N. & Gall, C. M. C. (1944) Psychogenic amnesia: the refusal to remember. Journal of Mental Science, 90, 511527.CrossRefGoogle Scholar
Parwatikar, S. D., Holcomb, W. R. & Meninger, K. A. (1985) The detection of malingered amnesia in accused murderers. Bulletin of the American Academy of Psychiatry and Law, 13, 97103.Google ScholarPubMed
Russell, W. R. & Nathan, P. W. (1946) Traumatic amnesia. Brain, 69, 280300.Google Scholar
Russell, W. R. & Smith, A. (1961) Post-traumatic amnesia in closed head injury. Archives of Neurology, 5, 429.Google Scholar
Sargant, W. & Slater, E. (1941) Amnesic syndromes in war. Proceedings of the Royal Society of Medicine, 34, 757764.Google Scholar
Schacter, D. L., Wang, P. L., Tulving, E. & Freedman, M. (1982) Functional retrograde amnesia: a quantitative case study. Neuropsychologia, 20, 523532.Google Scholar
Scoville, W. B. & Milner, B. (1957) Loss of recent memory after bilateral hippocampal lesions. Journal of Neurology, Neurosurgery and Psychiatry, 20, 1121.Google Scholar
Shimamura, A. P. & Squire, L. R. (1984) Paired-associate learning and priming effects in amnesia: a neuropsychological study. Journal of Experimental Psychology: General, 113, 556570.CrossRefGoogle ScholarPubMed
Speedie, L. J. & Heilman, K. M. (1982) Amnesic disturbance following infarction of the left dorsomedial nucleus of the thalamus. Neuropsychologia, 20, 597604.Google Scholar
Squire, L. R. (1977) ECT and memory loss. American Journal of Psychiatry, 134, 9971001.Google Scholar
Squire, L. R. (1980) Specifying the defect in human amnesia: storage, retrieval, and semantics. Neuropsychologia, 18, 368372.CrossRefGoogle ScholarPubMed
Squire, L. R. (1981) Two forms of human amnesia: an analysis of forgetting. Journal of Neuroscience, 1, 635640.Google Scholar
Squire, L. R. (1982) Comparisons between forms of amnesia: some deficits are unique to Korsakoff's syndrome. Journal of Experimental Psychology, Learning, Memory, Cognition, 8, 560572.Google Scholar
Squire, L. R. & Moore, R. Y. (1979) Dorsal thalamic lesion in a noted case of human memory dysfunction. Annals of Neurology, 6, 503506.Google Scholar
Squire, L. R. & Slater, P. C. (1983) ECT and complaints of memory dysfunction a prospective three-year follow-up study. British Journal of Psychiatry, 142, 18.Google Scholar
Squire, L. R., Cohen, N. J. & Nadel, L. (1984) The medial temporal region and memory consolidation: a new hypothesis. In Memory Consolidation (eds H. Weingartner & E. Parker). Hillsdale, NJ: Erlbaum Associates.Google Scholar
Starr, A. & Phillips, L. (1970) Verbal and motor memory in the amnesic syndrome. Neuropsychologia, 8, 7588.CrossRefGoogle Scholar
Stengel, E. (1941) On the aetiology of the fugue state. Journal of Me.ntal Science, 87, 572599.Google Scholar
Stuss, D. T., Alexander, M. P., Lieberman, A. & Levine, H. (1978) An extraordinary form of confabulation. Neurology, 28, 11661172.Google Scholar
Taylor, P. J. & Kopelman, M. D. (1984) Amnesia for criminal offences. Psychological Medicine, 14, 581588.Google Scholar
Teasdale, G. & Mendelow, D. (1984) Pathophysiology of head injuries. In Closed Head Injury: Psychological, Social, and Family Consequences (ed. N. Brooks). Oxford: Oxford University Press.Google Scholar
Tomlinson, B. E. & Corsellis, J. A. N. (1984) Ageing and the dementias. In Greenfield's Neuropathology (eds J. H. Adams, J. A. N. Corsellis & L. W. Duchen) 4th ed. London: Edward Arnold.Google Scholar
Torvik, A., Lindboe, C. F. & Rogde, S. (1982) Brain lesions in alcoholics. Journal of Neurological Science, 56, 233248.Google Scholar
Tulving, E. (1972) Episodic and semantic memory. In Organisation of Memory (eds E. Tulving & W. Donaldson). New York and London: Academic Press.Google Scholar
Victor, M., Adams, R. D. & Collins, G. H. (1971) The Wernicke-Korsakoff Syndrome. Philadelphia: F. A. Davis Co.Google Scholar
Warrington, E. K. & Weiskrantz, L. (1973) Short- and long-term memory defects in man. In The Physiological Basis of Memory (ed. J. A. Deutsch). London: Academic Press.Google Scholar
Warrington, E. K. & Weiskrantz, L. (1978) Further analysis of the prior learning effect in amnesic patients. Neuropsychologia, 16, 169177.Google Scholar
Weigartner, H., Miller, H. & Murphy, D. C. (1977) Mood-state-dependent retrieval of verbal associations. Journal of Abnormal Psychology, 86, 276284.Google Scholar
Weigartner, H., Miller, H., Grafman, J., Boutelle, W., Kaye, W. & Martin, P. R. (1983) Forms of memory failure. Science, 221, 380382.Google Scholar
Weiskrantz, L. & Warrington, E. K. (1979) Conditioning in amnesic patients. Neuropsychologia, 17, 187194.Google Scholar
Wilson, G., Rupp, C. & Wilson, W. W. (1950) Amnesia. American Journal of Psychiatry, 106, 481485.Google Scholar
Wilson, R. S., Kaszniak, A. W. & Fox, J. H. (1981) Remote memory in senile dementia. Cortex, 17, 4148.Google Scholar
Wolf, A. S. (1980) Homicide and blackouts in Alaskan natives. Journal of Studies of Alcohol, 41, 456462.Google Scholar
Woods, R. T. & Piercy, M. (1974) A similarity between amnesic memory and normal forgetting. Neuropsychologia, 12, 437445.Google Scholar
Zangwill, O. L. (1953) Disorientation for age. Journal of Mental Science, 99, 698701.CrossRefGoogle ScholarPubMed
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