Ganser's Syndrome
is a factitious disorder, characterised by the individual mimicking
behaviour yhey 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.
