Dromomania was a historical psychiatric diagnosis whose primary symptom was uncontrollable urge to walk or wander. [1] Dromomania has also been referred to as traveling fugue. [2] Non-clinically, the term has come to be used to describe a desire for frequent traveling or wanderlust. [3] [4] [5]
The term dromomania is derived from combining the Greek dromos , meaning "running" with the root mania . The term has sometimes been clinical and pathologizing, and other times been descriptive of unusual enthusiasm without negative or medicalizing connotations, reflecting the diverse uses of the term mania itself. [6]
In the 17th century, the term mania came to be used to describe any show of great enthusiasm for a specific activity or object. Later, it came to be used as a suffix for Greek words to refer to an irrational obsession, such as in the words hippomania, and nymphomania . At the same time emerged the French -manie, such as in bibliomanie, which was borrowed into English as bibliomania . The original sense of enthusiasm without the sense of irrationality continued, as can be seen in Coleridge's late (1772–1843) use of the term scribbleomania. [5]
Dromomania was a historical psychiatric diagnosis whose primary symptom was an irresistible urge to aimlessly wander, travel, or walk. [7] [8] Dromomania has also been referred to as traveling fugue. [2]
Some authors describe patients with this diagnosis as being "in an automatic state" as they traveled, [9] experiencing partial amnesia of the events of their journeys. [7] Other symptoms included a "loss of sense of personal identity, ... and impulses to homicide and suicide". [9]
Dromomania was regarded as a kind of impulse control disorder similar to kleptomania or pyromania. [10] [8] [11]
Dromomania was primarily described by French psychiatrists. The concept of dromomania was adapted in America into drapetomania, a mental disorder whose primary symptom was running away. This diagnosis was applied only to enslaved people. [12]
Modern bioethicist Henk A. M. J. ten Have regards dromomania as equivalent to the DSM IV diagnosis of dissociative fugue and the historical diagnoses of Wandertrieb (German) and automatisme ambulatoire (French). [7]
Many cases of dromomania have been described. [7] The most famous case was that of Jean-Albert Dadas, a gas-fitter from Bordeaux, France. Dadas would suddenly set out on foot and reach cities as far away as Prague, Vienna or Moscow with no memory of his travels. A medical student, Philippe Tissié, wrote about Dadas in his doctoral dissertation in 1887. [13]
Jean-Martin Charcot presented a similar case he called automatisme ambulatoire, French for "ambulatory automatism", or "walking around without being in control of one's own actions". [14]
Dromomania is one of a constellation of social constructs to describe contemporary nomadic lifestyles, along with bum, brodyaga, hobo, vagrant, divagate, itinerant, vagabond, transient, tramp, rogue, wanderer [15] [16] Within this constellation, dromomania is an extreme pathologizing term. [15] [16]
In the early 20th century, dromomania was classified as one of a number of criminal manias, which were understood to involve irresistible compulsions to act without any motivation and sometimes against the preferences of the actor. Other such criminal manias were kleptomania, pyromania, and dipsomania. [17] [18] The American Prison Association described all of these criminal manias as common among people with psychopathic personalities, who were also described as lacking in purpose and ambition. [18]
Dromomania was sometimes equated with propensity to vagrancy. [19] [16] The construct has been involved in the regulation of homelessness. [20] It associated with the belief that homeless travelers lose the capacity to live in homes and maintain stability. [16]
Travel writer Richard Grant has suggested that dromomania as a disorder is defined by sedentary cultures which pathologize a desire for travel that is present as an instinct in humans from their history as nomadic hunter-gatherers. [21] Frequent travelers such as Francis Xavier have been suspected of having dromomania. [22]
During the 20th century, this diagnosis fell into disuse. [7] However, since 2000 articles have appeared describing dromomania as a potential consequence of Alzheimer's disease, [23] dementia, [24] and delirium. [25] There have been attempts to treat dromomania with antipsychotic medications. [26]
More generally, the term is sometimes used to describe people who have a strong emotional or even physical need to be constantly traveling and experiencing new places, often at the expense of their normal family, work, and social lives.[ citation needed ]
Some authors have negatively referred to the high prevalence and cultural value of frequent long-distance travel in contemporary Western culture as hypermobility or dromomania. [27]
In a 1977 book, cultural theorist Paul Virilio criticized modernity for acculturating people to become insanely addicted to pursuing the future and unable to stop, which he characterized as "dromomania". [28] [29] [30] Virilio's analysis of contemporary culture has continued to be endorsed by other cultural theorists and regarded as even more accurate after the growth of finance capitalism and globalization. [31]
Bipolar disorder, previously known as manic depression, is a mental disorder characterized by periods of depression and periods of abnormally elevated mood that each last from days to weeks. If the elevated mood is severe or associated with psychosis, it is called mania; if it is less severe and does not significantly affect functioning, it is called hypomania. During mania, an individual behaves or feels abnormally energetic, happy, or irritable, and they often make impulsive decisions with little regard for the consequences; there is usually also a reduced need for sleep during manic phases. During periods of depression, the individual may experience crying, have a negative outlook on life, and demonstrate poor eye contact with others. The risk of suicide is high; over a period of 20 years, 6% of those with bipolar disorder died by suicide, while 30–40% engaged in self-harm. Other mental health issues, such as anxiety disorders and substance use disorders, are commonly associated with bipolar disorder.
Bipolar I disorder is a type of bipolar spectrum disorder characterized by the occurrence of at least one manic episode, with or without mixed or psychotic features. Most people also, at other times, have one or more depressive episodes. Typically, these manic episodes can last at least 7 days for most of each day to the extent that the individual may need medical attention, while the depressive episodes last at least 2 weeks.
The Diagnostic and Statistical Manual of Mental Disorders is a publication by the American Psychiatric Association (APA) for the classification of mental disorders using a common language and standard criteria. It is an internationally accepted manual on the diagnosis and treatment of mental disorders, though it may be used in conjunction with other documents. Other commonly used principal guides of psychiatry include the International Classification of Diseases (ICD), Chinese Classification of Mental Disorders (CCMD), and the Psychodynamic Diagnostic Manual. However, not all providers rely on the DSM-5 as a guide, since the ICD's mental disorder diagnoses are used around the world, and scientific studies often measure changes in symptom scale scores rather than changes in DSM-5 criteria to determine the real-world effects of mental health interventions.
Dissociative fugue, formerly called a fugue state or psychogenic fugue, is a rare psychiatric phenomenon characterized by reversible amnesia for one's identity in conjunction with unexpected wandering or travel. This is sometimes accompanied by the establishment of a new identity and the inability to recall personal information prior to the presentation of symptoms. Dissociative fugue is a mental and behavioral disorder that is classified variously as a dissociative disorder, a conversion disorder, and a somatic symptom disorder. It is a facet of dissociative amnesia, according to the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5).
A mental disorder, also referred to as a mental illness, a mental health condition, or a psychiatric disability, is a behavioral or mental pattern that causes significant distress or impairment of personal functioning. A mental disorder is also characterized by a clinically significant disturbance in an individual's cognition, emotional regulation, or behavior, often in a social context. Such disturbances may occur as single episodes, may be persistent, or may be relapsing–remitting. There are many different types of mental disorders, with signs and symptoms that vary widely between specific disorders. A mental disorder is one aspect of mental health.
A mood disorder, also known as an affective disorder, is any of a group of conditions of mental and behavioral disorder where the main underlying characteristic is a disturbance in the person's mood. The classification is in the Diagnostic and Statistical Manual of Mental Disorders (DSM) and International Classification of Diseases (ICD).
Pyromania is an impulse control disorder in which individuals repeatedly fail to resist impulses to deliberately start fires, to relieve some tension or for instant gratification. The term pyromania comes from the Greek word πῦρ. Pyromania is distinct from arson, the deliberate setting of fires for personal, monetary or political gain. Pyromaniacs start fires to release anxiety and tension, or for arousal. Other impulse disorders include kleptomania and intermittent explosive disorder.
Schizoaffective disorder is a mental disorder characterized by symptoms of both schizophrenia (psychosis) and a mood disorder - either bipolar disorder or depression. The main diagnostic criterion is the presence of psychotic symptoms for at least two weeks without prominent mood symptoms. Common symptoms include hallucinations, delusions, disorganized speech and thinking, as well as mood episodes. Schizoaffective disorder can often be misdiagnosed when the correct diagnosis may be psychotic depression, bipolar I disorder, schizophreniform disorder, or schizophrenia. This is a problem as treatment and prognosis differ greatly for most of these diagnoses. Many people with schizoaffective disorder have other mental disorders including anxiety disorders.
In 19th-century psychiatry, monomania was a form of partial insanity conceived as single psychological obsession in an otherwise sound mind.
Psychopathology is the study of mental illness. It includes the signs and symptoms of all mental disorders. The field includes abnormal cognition, maladaptive behavior, and experiences which differ according to social norms. This discipline is an in-depth look into symptoms, behaviors, causes, course, development, categorization, treatments, strategies, and more.
Ganser syndrome is a rare dissociative disorder characterized by nonsensical or wrong answers to questions and other dissociative symptoms such as fugue, amnesia or conversion disorder, often with visual pseudohallucinations and a decreased state of consciousness. The syndrome has also been called nonsense syndrome, balderdash syndrome, syndrome of approximate answers, hysterical pseudodementia or prison psychosis.
Drapetomania was a proposed mental illness that, in 1851, American physician Samuel A. Cartwright hypothesized as the cause of enslaved Africans fleeing captivity. This hypothesis was based on the belief that slavery was such an improvement upon the lives of slaves that only those suffering from some form of mental illness would wish to escape.
Cyclical variations in moods and energy levels have been recorded at least as far back as several thousand years. The words "melancholia" and "mania" have their etymologies in Ancient Greek. The word melancholia is derived from melas/μελας, meaning "black", and chole/χολη, meaning "bile" or "gall", indicative of the term's origins in pre-Hippocratic humoral theories. A man known as Aretaeus of Cappadocia has the first records of analyzing the symptoms of depression and mania in the 1st century of Greece. There is documentation that explains how bath salts were used to calm those with manic symptoms and also help those who are dealing with depression. Even today, lithium is used as a treatment to bipolar disorder which is significant because lithium could have been an ingredient in the Greek bath salt. Centuries passed and very little was studied or discovered. It wasn't until the mid-19th century that a French psychiatrist by the name of Jean-Pierre Falret wrote an article describing "circular insanity" and this is believed to be the first recorded diagnosis of bipolar disorder. Years later, in the early 1900s, Emil Kraepelin, a German psychiatrist, analyzed the influence of biology on mental disorders, including bipolar disorder. His studies are still used as the basis of classification of mental disorders today.
The classification of mental disorders, also known as psychiatric nosology or psychiatric taxonomy, is central to the practice of psychiatry and other mental health professions.
The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), is the 2013 update to the Diagnostic and Statistical Manual of Mental Disorders, the taxonomic and diagnostic tool published by the American Psychiatric Association (APA). In 2022, a revised version (DSM-5-TR) was published. In the United States, the DSM serves as the principal authority for psychiatric diagnoses. Treatment recommendations, as well as payment by health care providers, are often determined by DSM classifications, so the appearance of a new version has practical importance. However, some providers instead rely on the International Statistical Classification of Diseases and Related Health Problems (ICD), and scientific studies often measure changes in symptom scale scores rather than changes in DSM-5 criteria to determine the real-world effects of mental health interventions. The DSM-5 is the only DSM to use an Arabic numeral instead of a Roman numeral in its title, as well as the only living document version of a DSM.
Bipolar II disorder (BP-II) is a mood disorder on the bipolar spectrum, characterized by at least one episode of hypomania and at least one episode of major depression. Diagnosis for BP-II requires that the individual must never have experienced a full manic episode. Otherwise, one manic episode meets the criteria for bipolar I disorder (BP-I).
Grisi siknis is a contagious, culture-bound syndrome that occurs predominantly among the Miskito people of eastern Central America, and affects mainly young women. It is also known as "grisi munaia", "Chipil siknis", and "Nil siknis". More recently, cases occurring amongst people of Spanish descent have also been reported.
Childhood schizophrenia is similar in characteristics of schizophrenia that develops at a later age, but has an onset before the age of 13 years, and is more difficult to diagnose. Schizophrenia is characterized by positive symptoms that can include hallucinations, delusions, and disorganized speech; negative symptoms, such as blunted affect and avolition and apathy, and a number of cognitive impairments. Differential diagnosis is problematic since several other neurodevelopmental disorders, including autism spectrum disorder, language disorder, and attention deficit hyperactivity disorder, also have signs and symptoms similar to childhood-onset schizophrenia.
Disruptive mood dysregulation disorder (DMDD) is a mental disorder in children and adolescents characterized by a persistently irritable or angry mood and frequent temper outbursts that are disproportionate to the situation and significantly more severe than the typical reaction of same-aged peers. DMDD was added to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) as a type of depressive disorder diagnosis for youths. The symptoms of DMDD resemble many other disorders, thus a differential includes attention-deficit/hyperactivity disorder (ADHD), oppositional defiant disorder (ODD), anxiety disorders, and childhood bipolar disorder, intermittent explosive disorder (IED), major depressive disorder (MDD), and conduct disorder.
Externalizing disorders are mental disorders characterized by externalizing behaviors, maladaptive behaviors directed toward an individual's environment, which cause impairment or interference in life functioning. In contrast to individuals with internalizing disorders who internalize their maladaptive emotions and cognitions, such feelings and thoughts are externalized in behavior in individuals with externalizing disorders. Externalizing disorders are often specifically referred to as disruptive behavior disorders or conduct problems which occur in childhood. Externalizing disorders, however, are also manifested in adulthood. For example, alcohol- and substance-related disorders and antisocial personality disorder are adult externalizing disorders. Externalizing psychopathology is associated with antisocial behavior, which is different from and often confused for asociality.