Ganser Syndrome

What is Ganser Syndrome?

Ganser syndrome is a relatively rare dissociative disorder that has a range of symptoms, including a nonsensical answer to questions. The syndrome itself can develop in prison inmates that are attempting to persuade their prison guards and overseers to grant them some form of leniency while imprisoned.

There are many other names for the condition, including Balderdash Syndrome, prison psychosis, pseudodementia, nonsense syndrome, and hysterical pseudodementia. In most cases, Ganser syndrome appears to be much more common in males in their late teens to early adult years, with some estimates reporting as much as 80% of the diagnosed cases.

Ganser syndrome was documented first by Sigbert Ganser in 1898.

He was working with three inmates at the time of his discovery and described a series of hysterical episodes that he eventually found to stem from the desire of the inmates to avoid unpleasant situations. He determined that it was in relation to current living conditions and can have an association with a head injury.

Further studies conducted in the last several decades have uncovered additional information. Patients who exhibit the symptoms underwent intense studies to reveal more about the underlying causes, as well as the mental state of people who develop this unusual condition. Although the condition is created by the person themselves, there is generally some type of underlying cause, or trigger, that creates a need to gain favor or attention from authority figures or individuals such as doctors and counselors.

Once a person receives a diagnosis, the patient will undergo a series of therapy sessions, as well as close supervision to ensure they do not become a danger to themselves or others in an attempt to seem more convincing. Even though Pseudodementia itself is not a dangerous condition, the person may become a danger the longer the condition persists.

The level of danger can also fluctuate depending on impending circumstances.

If the patient feels they have something to gain, such as freedom or favorable treatment, they may ramp up efforts to persuade others of their mental illness. This is one of the primary concerns for people exhibiting this type of behavior.

Ganser Syndrome Symptoms

The symptoms of Ganser syndrome vary from person to person depending on their mental history, as well as their medical history.

The patient will normally exhibit symptoms they relate to a mental illness or disorder.

The symptoms are very subjective, but usually, the person will give answers that have no bearing on the question. For example, if the prison psychologist or guard asks the inmate what color the sky is, the inmate may answer with “pancakes”, or some other nonsense answer that makes them appear to be mentally ill.

In other cases, they will give approximate answers, or they will give answers that acknowledge they understand the question, but they give the wrong answer. For example, if the therapist asked how many legs a person has, the patient would answer with something like “four” or another wrong number. This disorder is also common in individuals that are facing legal ramifications or harsh sentences for crimes they committed.

Although Ganser syndrome is more prevalent in individuals with mental illnesses, it can manifest in people without mental illnesses that spur a desire to illicit a reaction from others. People suffering from paresis, depressive disorders, schizophrenia, and alcohol and drug addiction may also exhibit symptoms of Ganser syndrome. There is no data showing a definitive cause of Ganser disorder, which means that anyone can display the symptoms depending on their current thinking and the conditions affecting their everyday life at that time.

There does not seem to be an organic cause for Ganser syndrome. The disorder itself seems to be the will of the person exhibiting the symptoms. People with Ganser syndrome tend to describe very vivid hallucinations that are far more detailed and imaginative than those exhibited by people who suffer from schizophrenia.

The opinions of mental health professionals vary regarding the cause of the disorder.

Some feel as though it stems from an already present mental illness, while others still feel it is a completely fabricated state in which the patient seeks a certain type of attention or wishes to manipulate a situation to their advantage. Ganser syndrome symptoms are usually short term and can consist of any claim the patient makes regarding their mental health.

One of the hallmark symptoms, vorbeireden (approximate answers), highlights and help doctors diagnose the disorder. Some people who suffer from Ganser syndrome report short bouts of amnesia, which tend to occur during an episode or just after the episode. Still, others claim to have severe bouts of depression immediately following an episode.

The estimates are that these symptoms tend to pass after a few days and do not pose long-term consequences in most cases.

Ganser Syndrome Causes

The cause of Ganser syndrome is the patient’s will to convince others they are mentally ill.

Even if they are actually suffering from a mental illness, the purpose of the complaints about symptoms is to make others think they are experiencing a condition that renders them impaired or unable to function in a normal capacity. Individuals that stand to benefit from being mentally ill at a given time will create a list of symptoms, such as severe hallucinations or the inability to understand normal communications and concepts.

The diagnosis for the condition can become exceedingly difficult because the professional is dealing with deception and images the patient wishes to project to others. Getting to the cause of the issue can become time-consuming and can involve a great deal of detective work. Professionals rely on their own knowledge of other conditions the patient could be mimicking in order to discern the condition. Ganser syndrome rarely becomes diagnosed, and there are only around 100 confirmed cases on record.

It may develop as a reaction to extreme stress, head injuries, or even a prolonged illness. Some of the symptoms that people describe include hallucinations that are both auditory and visual, a cloudy consciousness, and approximate answers to questions.

Ganser syndrome is also in some cases classified in the Somatic Symptom Disorder category. For example, it may also become labeled as Conversion Disorder or Functional Neurological Symptom Disorder. This is only after other ailments, disorders, and illnesses are ruled out. Some of the other conditions doctors may rule out, for example, are dementia, head injuries, or even a stroke.

Ganser syndrome is also sometimes associated with physical or mental disorders that manifest themselves in a physical manner, such as Tourette’s syndrome, alcoholism, frontal-temporal dementia, and head injuries. Professionals know that a majority of patients who exhibit Ganser symptoms may also have an underlying personality disorder that requires treatment. A typical person displaying those types of behaviors tends to have a problem with rules and authority in general, and are in many cases considered antisocial, sociopaths, or psychopaths.

Individuals with these conditions often look for excessive amounts of attention from others and resort to unorthodox means to gain the attention they crave.

Ganser Syndrome Treatments

The treatments for Ganser syndrome can vary depending on the individual’s medical, mental, and criminal history. Generally, diagnosis is difficult and takes a considerable amount of time.

Diagnosis must occur before any specific treatment can take place.

In most cases, the treatment takes place after the diagnosis phase through therapy and one on one sessions with a mental health professional. The therapist must find the reason for the patient’s desire to project a certain image regarding their mental health. Once the cause of the issue comes to light, the patient can begin therapy for whatever the situation is that caused them to develop Ganser syndrome. There may be underlying psychological issues that may require additional long-term treatment to give the patient relief.

Treatment can really depend on the patient’s current situation at the time. Individuals serving prison terms may be limited to the methods of treatment available to them in the corrections system. Ganser syndrome can also be a factitious disorder, but if they perpetuate symptoms for things such as leniency, days off, or even monetary gain, it would be considered malingering.

One of the main treatment goals that is associated with Ganser syndrome is eliminating the chance that the patient can harm themselves as a result of attention or if they begin to feel as though their attempts are not having the desired effect. Some people will elevate their symptoms in an attempt to try to convince professionals if they feel they are being met with resistance.

Ganser Syndrome Prevention

Like many other psychological conditions, Ganser syndrome is best prevented by keeping other mental conditions under control with a combination of therapy and medication. If the patient is incarcerated, they may need to have a psychologist see them regularly to discuss the underlying reason for the claims of mental distress and false symptoms.

Upon developing symptoms, the patient should be evaluated, which may take several sessions. Once the professional diagnosis is Ganser syndrome, the patient can begin taking steps to undergo the treatment necessary for them to refrain from complaining of non-existent symptoms.

Because in some cases the disorder is related to an accident or illness, there is no way to prevent the patient from developing these symptoms after the event or events occur. Monitoring individuals by using a combination of supervision and therapy is the most effective method to stop individuals from deciding to gain the attention of both personal contacts as well as professional therapists and doctors.

Ganser syndrome is complex and difficult to diagnose. There are few people in the world that are currently diagnosed with the disorder. It takes a great amount of testing and therapy for doctors to deliver a Ganser syndrome diagnosis. The condition is normally present in men that are incarcerated, but there have been some instances where females of a fairly young age have also received this diagnosis. It is believed that in most cases, the patient feels that they can gain additional attention or favorable treatment if they portray symptoms of an illness, such as schizophrenia.

Most medical professionals will also look to find any underlying mental illnesses because in many cases, Ganser syndrome crops up as a result of an already present mental condition.

The outlook for patients that have Ganser Syndrome is relatively good, but is a reflection of a need for therapy, so ongoing therapy is generally recommended to help control any additional bout in the long term. If Ganser syndrome develops because of a head injury, a medical professional will closely monitor the progress of the injury to ensure proper healing and simultaneously treat the Ganser syndrome to help the patient have the best possible outcome.

Last Reviewed:
September 22, 2017
Last Updated:
December 26, 2017
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