Ganser’s syndrome: its most frequent symptoms and causes

This rare psychotic disorder is associated with hallucinations and loss of identity.

In the medical and psychological literature we find mentions of Ganser syndrome, a very rare mental disorder characterized by symptoms such as approximate answers to simple questions, complex hallucinations and conversive phenomena.

In this article we will discuss the causes and symptoms of Ganser syndrome..

What is Ganser syndrome?

Ganser's syndrome is a very rare clinical picture that was first described in 1898. The name given to this phenomenon comes from its discoverer: the German psychiatrist Sigbert Ganser. We also find the terms "hysterical pseudodementia", "pseudodementia syndrome" and "prison psychosis"..

The latter name refers to the fact that Ganser syndrome has been identified with higher than usual frequency in inmate populations. In most of these cases, the symptoms are most likely an attempt to receive better treatment from prison staff or other inmates.

The most characteristic symptom of Ganser's syndrome is the pararesponses, or approximate responses. The most characteristic symptom of Ganser syndrome is the para-answers or approximate answers; these are flawed but relatively close to the truth answers to simple questions. The other signs of this condition include conversive phenomena, echophenomena and apparent alterations of consciousness, among others.

The few prevalence studies available indicate that Ganser syndrome occurs more commonly in males than in females. more common in males than in femalesin a 3:1 ratio. The average age of diagnosis would be somewhat above 30 years, although it sometimes occurs in children. However, very little is known about this phenomenon because of its extreme infrequency.

Possible causes and psychological hypotheses

Ganser's syndrome has traditionally been classified in the category of factitious disorders, which are characterized by the feigning of an illness in order to obtain a better life. the feigning of an illness in order to achieve a "patient role".. The other typical phenomenon of this class is Münchausen's syndrome, in which the person feigns illness or psychological trauma in order to obtain social reinforcement.

In this sense, factitious disorders can be distinguished from simulation. In the vocabulary of clinical psychology and other related disciplines, the term "simulation" is used to refer to cases in which an illness or mental disorder is faked for a purpose other than obtaining the role of the patient, such as financial gain.

There is a widespread understanding of Ganser's syndrome as a dissociative disorder, so that it would be more similar to a dissociative disorder.It would be more similar to phenomena such as depersonalization, derealization and dissociative amnesia. Dissociative experiences consist of separations of cognitive processes (including consciousness) that arise in reaction to stress.

However, at present, the most accepted explanation of the causes of Ganser's syndrome is defined as a disorder of a psychotic nature. The association of this clinical picture with schizophrenia, intoxication by alcohol and other psychoactive substances and severe depressive disorders is noteworthy.

Main symptoms and signs

Pararesponses, conversive symptoms, alterations of consciousness, and pseudohallucinations. and pseudohallucinations are the four most defining features of Ganser syndrome. It is also important to highlight the echophenomena, which occur with some frequency in this clinical context, and the high levels of stress and anxiety detected in these individuals.

1. Approximate responses or pararesponses

The pararesponses consist of answers that are relatively close to reality that are given to questions that are easy to answer. In many cases, Ganser syndrome is conceptualized around this peculiar manifestation; in fact, the DSM-IV manual places the approximate responses at the core of the criteria for the diagnosis of Ganser syndrome.

2. Somatic conversion symptoms

Conversion consists of the presence of physical symptoms, such as Pain or sensory and pain or sensory and motor deficits, in the absence of an identifiable organic cause. identifiable organic cause. Conversion disorder is currently in question; the DSM-5 includes it in the category "somatic symptom disorders", which also includes factitious disorder, among others.

3. Altered level of consciousness

The two symptoms related to the level of alertness, and therefore consciousness, that appear most commonly in Ganser syndrome are the sensation of mental confusion and loss of personal identity.. In general, people with this clinical condition may have difficulty reacting to and processing environmental stimuli.

4. Complex hallucinations

People with Ganser syndrome often report very elaborate hallucinations in any of the sensory modalities. Given that in psychiatric disorders such as schizophrenia the hallucinations are usually auditory and simple, these types of accounts can serve as a clue in the diagnosis of Ganser syndrome. can serve as a clue in the diagnosis of this rare syndrome..

5. Echophenomena

The echophenomena or echosymptoms are behaviors of imitation or repetition that occur without voluntary control of the subject. The stimuli of the environment that are reproduced may be actions (echopraxia), verbalizations (echolalia), or facial expressions (ecomimia), among others.