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 [ See
Therapy Section ]:
Supportive
psychotherapy and/or cpounselling are the main elements of therapy
for Ganser Syndrome.
Pharmacotherapy
[ See
Psychopharmacology Section ] :
Medication
usually is not used, unless the person also suffers from Depression,
Anxiety or a Personality Disorder
