Ganser Syndrome - An Overview

What Is Ganser Syndrome?

Ganser syndrome has been known by many names, such as nonsense syndrome, prison psychosis, balderdash syndrome, syndrome of approximate answers, or hysterical pseudodementia. It is a rare disorder that was first described by Sigbert Josef Maria Ganser in the late 1800s. Sigbert gave it the name prison psychosis, as he first noticed it in the prisoners. Under the effect of the syndrome, an individual portrays a false pretense of being physically or mentally sick. This conquest was built in order to get parol or easy hearing and leniency from the judge and other court officials. In the prisoners suffering from Ganser syndrome, other mental illnesses were commonly present. Some of the commonly seen mental illnesses of a Ganser patient were schizophrenia, depression, and anxiety.

Ganser syndrome is a controversial disorder, as its place and category are yet to be decided. In addition, the individuals suffering have the same opinion of themselves. Individuals suffering have difficulty being coherent. Often in rare and extreme cases, individuals suffering mimics the same behavior as that of a schizophrenic, that is, mimicking a mental illness. The golden feature of the illness is their inability to be coherent and the patient’s ability to give almost correct answers. The most commonly used example or test used on these patients is, asking them basic math questions, such as 3+3, the answer, however obvious, will be missed by the patient; they will give near obvious or nonsensical (as its namesake) answers, such as 3+3 for them would be 7. It was also clearly documented while diagnosing the said symptoms was the fact that the individual understood the question coherently, but while replying, they suffered from cloudy consciousness and answered in a near approximate manner.

What Category Does Ganser Syndrome Falls Under?

Initially, Ganser syndrome was subjected to be classified under factitious disorder. Factitious disorder is a mental condition wherein an individual deceives or fools others by appearing sick or purposefully injuring oneself to be sick. Notwithstanding this, the American Psychiatry Association (APA) changed this classification and further documented it in the fourth edition of the diagnostic and statistical manual (DSM-IV) as dissociative disorder not otherwise specified (NOS).

Dissociative disorder is a mental disorder wherein the individual suffering often experiences an out-of-body experience or a dissociation between themselves and their thoughts, body, emotions, and surroundings. Ganser syndrome was thought to be a part of the dissociative syndrome due to its overlapping symptoms. However, with the new edition, that is, the fifth edition of the diagnostic and statistical manual (DSM-V), the said disorder has been omitted from being a mental disorder.

What Causes Ganser Syndrome?

Epidemiological studies have stated that fewer than 100 people have been reported to be suffering from Ganser syndrome. It is hard to determine the exact cause of it; hence psychologists have stated some of the causes that can lead to the development of Ganser syndrome. Some of the probable causes are:

• Stressful conditions, such as being on trial (as seen in the case of prisoners).

• Alcoholism (chronic and excessive use of alcohol).

• Head trauma (causing injury to the parts of the brain).

• Stroke.

• Depression (individuals with depression also develop Ganser syndrome).

• Schizophrenia (there are high risks of individuals suffering from schizophrenia having Ganser syndrome).

• Personality disorders (often antisocial personality disorder and histrionic personality disorder).

• Other psychiatric disorders such as mood disorders, eating disorders, and dementia.

• Neurological disorders such as epilepsy and seizures.

• Emotional trauma.

• Post-traumatic stress disorder (PTSD).

What Are the Symptoms of Ganser Syndrome?

Ganser syndrome is when an individual puts up a sham or an act appearing to be sick, both physically and mentally. Except for this classical sign, other symptoms include:

1. Episodes and symptoms mimic that of other mental illnesses such as schizophrenia and depression.

2. Inability to be coherent.

3. Vorbeireden (when an individual is unable to give accurate answers or give nonsensical answers).

4. Hysterical paralysis (inability to move extremities such as arms or legs).

5. Episodes of amnesia (loss of memory).

6. Use of ludicrous statements and speech.

7. Episodes of hallucination.

What Is the Treatment of Ganser Syndrome?

Patients with Ganser syndrome can live a relatively comfortable life, but a proper diagnosis and treatment plan is advised. Untreated cases can be fatal. Therefore, the main aim of the treatment is to provide symptomatic relief to the patient. However, since the patient suffering from Ganser syndrome pretends to be mentally or physically ill, providing symptomatic relief is tough.

The treatment plan for Ganser syndrome is patient-specific and is designed to help the patient’s psyche. The treatment plan includes:

1. Psychotherapy: Psychotherapy is the treatment of choice in Ganser syndrome. Psychotherapy is also known as talk therapy or counseling. It is advised in the case of emotional, psychological, and behavioral disorders. It aims to make the patient feel at ease for them to talk about their fears, emotions, and feelings they suffer and feel. There are many types of psychotherapy; the therapy matching the criteria of the patient depends on the psychologist.

Patients suffering from Ganser syndrome are motivated to talk about their pretenses and their illnesses. As a result, they are made comfortable trusting their psychologists for them to be able to speak with their counselor comfortably.

Psychotherapy has proven to be an effective mode of treatment, individually and even as an adjunction to medicinal therapy.

2. Medicinal Therapy: This form of therapy is only prescribed for patients suffering from other mental illnesses as well, such as depression, schizophrenia, and anxiety disorders. In case an individual has severe episodes of depression and anxiety, immediate medicinal therapy is prescribed to help combat these episodes. Likewise, in the case of mild to moderate schizophrenia, medicinal treatment is prescribed; however, in the case of severe schizophrenia, hospitalization is advised as it can be life-threatening.

Ganser syndrome is a rare, complicated, but treatable condition, given proper treatment is provided.

Conclusion:

After epidemiological research, and literature studies provided, currently, Ganser syndrome does not fall under any mental disorders. However, it is a mental illness that is treatable with the help of psychotherapy. Golden signs of Ganser syndrome include the inability of the individual to answer a straightforward question appropriately.