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Flashback

Synonym: involuntary recurrent memory
German: Flashback

1 Definition

A flashback is the phenomenon of involuntarily and temporarily re-experiencing memories, caused by a specific trigger. Flashbacks can be subdivided into natural flashbacks which are caused by triggers from childhood (sounds, smells, images, places) and pathological flashbacks, associated with mental disorders and substance abuse. Flashbacks can contain different emotions, including anger, happiness, fear, and grief. They usually only last a few seconds, up to one minute. Episodes might be accompanied by phenomenons such as sweating, palpitations, and shaking. Drug-induced flashbacks can cause the patient to re-experience previous hallucinogenic episodes. Those also have a short duration and occur episodically.

2 Triggers and differential diagnosis

While taking the patient's medical history, substance abuse should be ruled out and patients should be asked about the contents of their flashbacks. Furthermore, drug testing is recommended to rule out acute intoxication. A physical exam and laboratory tests should be carried out to make sure there are no organic causes. In case of recurring frightening flashbacks, an extended psychological exam (SCID-I) is warranted. The following differential diagnostic possibilities are to be considered:

  • Acute stress disorder (ASD)
  • Posttraumatic stress disorder (PTSD)
  • Fatigue
  • Alcohol abuse
  • Hallucinogen persisting perception disorder (HPPD)
  • Obsessive–compulsive disorder (OCD)
  • Depression
  • Near-death experiences
  • Homesickness
  • Epilepsy
  • Substance abuse (LSD, Mescaline, Psilocybin)
  • Misuse of medicines (Ketamine)
  • Intoxication

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