Diagnostic criteria for Ganser's Syndrome
( cautionary statement )

Ganser's Syndrome is a factitious disorder, characterised by the individual mimicking behaviour they think are typical of a psychosis, by providing nonsensical or wrong answers to questions, and doing things incorrectly. The answers given, however, are usually so close to the question as to reveal that the patient has understood the question. Also called nonsense syndrome, balderdash syndrome, syndrome of approximate answers, pseudodementia or prison psychosis ( The syndrome is described most frequently in prison inmates form whom it may represent an attempt to gain leniency from prison or court officials ), classified in DSM-IV as one of the dissociative disorders. People with Ganser Syndrome have short-term episodes of odd behavior similar to that shown by people with serious mental illnesses. Diagnosing Ganser syndrome is very challenging, not only because some measure of dishonesty is involved but also because it is very rare hoever the main characteristic of the syndome are:

• The person may appear confused and make absurd statements.
• Report hallucinations. * Vorbeireden, or approximate answers, in which the person gives nonsense answers to simple questions.
• Intentional production of physical or psychological symptoms.
• The patient's motivation is to assume the sick role.
• External motives (such as financial gain) are absent.

Associated Features:

The syndrome is commonly associated with:

Dissociative Amnesia or Fugue.
Hallucinations.
Somatic Conversion.
Possible Brain Injury.
More commen in Men than Women.
Major Personal loss experienced.
Period of Depression experienced after an episode.
Loss of Memory during periods of the episode.

Differential Diagnosis:

Some disorders have similar symptoms. The clinician, therefore, in his diagnostic attempt, has to differentiate against the following disorders which need to be ruled out to establish a precise diagnosis.

Schizophrenia.
Malingering.
Antisocial Personality Traits.
Borderline Personality Disorder.
Histrionic Personality Disorder
Post Traumatic Stress Disorder.
Factitious Disorder (Munchausen Syndrome)

Cause:

Ganser's syndrome is an unusual dissociative reaction to extreme stress. It has sometimes been labeled as malingering, but is more often classified as a factitious disorder. There is no single explanation for this disorder. Factitious disorders in general usually attributed to underlying personality disorders; child abuse or the wish to repeat a satisfying childhood relationship with a doctor. Ganser syndrome therefore is a desire to avoid responsibility or an unpleasant situation. There also are physical problems that may cause the symptoms of Ganser syndrome. These include alcoholism, head injury and stroke. In many cases, the suffering of a major personal loss has also been implicated.

Treatment:

Treatment is usually limited to recognition of the condition and the refusal to give unnecessary medications or to perform unneeded medical procedures. Some clinicians have tried psychotherapeutic treatment, and there are reports that antidepressant or antipsychotic medications may be helpful in certain cases.

Counseling and Psychotherapy:

Supportive psychotherapy and/or cpounselling are the main elements of therapy for Ganser Syndrome.

Pharmacotherapy:

Medication usually is not used, unless the person also suffers from Depression, Anxiety or a Personality Disorder.