Ganser syndrome is a rare and somewhat controversial diagnosis. It was first described by Siegbert Ganser in 1898 and is sometimes called "prison psychosis" because it was first observed in prisoners. With this condition, people give not-quite-correct answers to simple questions, such as saying that a dog has five legs or that 1 plus 2 equals 6. They may also seem confused, report hallucinations, and even have physical symptoms like shaking or muscle weakness.
There are no clear criteria for diagnosing this little-known condition. And doctors have disagreed over the years about what type of disorder it is. It was once considered to be factitious disorder, in which someone fakes medical or psychiatric symptoms because of an inner need to be seen as ill or injured.
The World Health Organization now classifies Ganser syndrome as a dissociative and conversion disorder. With dissociative disorders, you feel detached from your own thoughts, memories, and identity. In conversion disorders, mental health conditions cause actual physical symptoms.
What Are the Symptoms of Ganser Syndrome?
People with Ganser syndrome have short-term episodes of odd behavior similar to that shown by people with other serious mental illnesses. You may appear confused, make absurd statements, and report hallucinations such as the experience of sensing things that are not there or hearing voices.
A classic symptom of Ganser syndrome is vorbeireden. This is when you give nonsense answers to simple questions. In addition, you may report physical problems such as an inability to move part of the body. Loss of memory (amnesia) of the events that occurred during an episode is common.
What Causes Ganser Syndrome?
Little is known about this unusual disorder, but it's believed to be a reaction -- either conscious or unconscious -- to extreme stress. It's thought to be a coping mechanism for intense distress, like being imprisoned or being involved in a serious accident. People with a history of psychological stress, such as those who were abused as children, may be at higher risk.
Other things that may increase your risk include:
Alcoholism and other types of substance abuse
Infections that affect your brain
Brain tumor
Stroke
Other mental health issues such as schizophrenia
How Common Is Ganser Syndrome?
Ganser syndrome is very rare. It is more common in men than in women and most often occurs in the late teens and early adult years.
How Is Ganser Syndrome Diagnosed?
Diagnosing Ganser syndrome is challenging. Doctors must rule out any possible physical problems, such as stroke or head injury, or other psychological conditions as the cause of the symptoms before considering a diagnosis of Ganser syndrome.
If the doctor finds no physical reason for the symptoms, they may refer the person to a psychiatrist or psychologist, mental health professionals who are specially trained to diagnose and treat mental illnesses. Psychiatrists and psychologists use specially designed interviews and assessment tools to evaluate a person for psychiatric conditions. The doctor bases their diagnosis on the use of these tools as well as the exclusion of other physical or mental illnesses and their observation of the patient's attitude and behavior.
How Is Ganser Syndrome Treated?
Ganser usually goes away on its own, but it's hard to predict whether and when symptoms are likely to stop. This is partly because people with Ganser Syndrome often present with symptoms not just simply in response to a stressful event, but because the condition often reflects their limited ability to cope effectively with stresses when they occur.
Supportive psychotherapy (a type of counseling), and monitoring for safety and a return of symptoms are the main treatments for Ganser syndrome. Medication is not generally used, unless the person also suffers from depression, anxiety, or psychosis.
What Is the Outlook for People With Ganser Syndrome?
It is difficult to predict whether and when symptoms of Ganser syndrome are likely to end. The likelihood for recovery from Ganser syndrome can vary greatly depending on whether the symptoms arose suddenly in response to a stressful experience or reflect a more long-term pattern.
Can Ganser Syndrome Be Prevented?
There is no known way to prevent this condition.
