Ganser's syndrome

A factitious disorder, characterised by the individual mimicking behaviour he or she thinks is typical of a psychosis, 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 (Vorbeireden, paralogi). If shown a glove, the patient may evade the question by answering that it is a hand. The patient’s rapid response to questions and his retention of details are unlike the reactions seen in dementia. It can be a form of malingering, occurring especially in prisoners awaiting trial, probably with the intention of influencing a forensic evaluation or a court decision. There is also hallucinations, clouded sensorium, somatic conversion, and amnesia. The person is not psychotic. The syndrome was originally described in male prisoners with brain injuries. It has also been described in a 12 year old boy with a head injury*.

Sigbert Ganser first described the syndrome while working at a penal institution in Halle, Germany. He had noted a syndrome in three prisoners, the features of which included approximate answers to simple questions, perceptual abnormalities such as visual and auditory hallucinations, clouding of consciousness, and symptoms of somatic conversion (also known as functional or hysterical symptoms).

"I must openly admit that after observing many details there is a great deal that is obscure to me"

*Peter Miller, David Bramble, Neil Buxton, in: Journal of the American Academy of Child and Adolescent Psychiatry, Baltimore, 1997, 36(1):112-115.

• S. J. M. Ganser:
  Über einen eigenartigen hysterischen Dämmerzustand.
  Archiv für Psychiatrie und Nervenkrankheiten, Berlin, 1898, 30: 633-640.
  English translation by C.E. Schorer: A peculiar hysterical state. British Journal of Criminology, 1965, 5: 120-126. Diagnostic and statistical manual of mental disorder.
  3rd edition, Washington, American Psychiatric Association, D. C., 1987, pp. 77.