Vagrancy

VAGRANCY, a term used in psychiatry to denote a pathological condition characterized by patients leaving their homes and wandering for some time outside the home; other designations are dromomania, poriomania, fugue, and automatic wandering (automatisme ambulatoire). There is no general agreement among authors on the exact meaning and differentiation of these terms; some use the terms vagrancy and fugue as synonyms, while others try to sharply distinguish vagrancy from other, more acute conditions of this type. It is most correct to understand vagrancy as a more chronic condition: the patient wanders for a very long time, sometimes many years, moving from one place to another; vagrancy becomes as it were a second profession for the patient, he wanders with clear consciousness, i.e., he wanders in the full sense of the word. When wandering is of a more acute nature, lasting sometimes only a few days and coinciding only with the acute period of mental illness, and often arises periodically, then other terms mentioned above are more appropriate to these conditions, and each of these terms, despite their certain commonality, has its own nuances and features. The more general of these is the term "fugue," including all acute phenomena both with and without disturbance of consciousness. Dromomania, poriomania are impulsive acts arising from a special change in mood, of a negative, gloomy character, with a special desire to free oneself from something heavy, with a compulsive need for discharge, with a greater or lesser degree of clouded consciousness. These conditions are most often found in epileptics, in connection with their characteristic mood disorders, and in young psychopaths, especially during the pubertal period, sometimes as a reaction to surrounding irritations: heavy experiences, insults, humiliations, change of place. "Automatic wandering" is characterized by the fact that the subject, while having clouded, changed consciousness, retains all the appearance of conscious behavior and meaningful actions. This includes the well-known case of one patient who completely aimlessly made a journey from Paris to Bombay, maintaining the behavior of a seemingly healthy person. Such conditions are most often observed in hysterics, and sometimes in epileptics and alcoholics. - Not every case of vagrancy is a consequence of mental illness; in a number of cases, its causes must be sought in economic and living conditions. One cannot also deny that in general the conditions surrounding the patient play an important role in the development of vagrancy and fugue, arising on the basis of mental illness. Vagrancy and fugue are not independent diseases; they are only syndromes that occur in various diseases. Thus, they are described in various psychopaths, hysterics, epileptics, psychasthenics, neurasthenics, in early dementia, in congenital feeble-mindedness, chronic alcoholism, progressive paralysis, senile dementia, in states of exaltation, depression, and confusion. These syndromes also occur in children, both in normal and pathological states. The psychological prerequisites for explaining the occurrence of vagrancy and fugue are extremely diverse, depending on the type of disease on the basis of which they arise: sometimes it is a disorder of memory, sometimes a general weakening of the psyche and emotional dullness, sometimes hallucinations and delusional ideas or a change in mood, clouding of consciousness, and finally, a tendency to fantasize, to lie, to desire to play some special role. Some see in vagrancy and fugue a reflex freed from the influence of consciousness, from conscious deliberation, conscious choice of one's acts, i.e., a pathological condition occurring when the entire superstructure over the reflex apparatus, which is called conscious life, is disrupted.