Ganser Syndrome

Medically Reviewed by Smitha Bhandari, MD on May 15, 2023
3 min read

Ganser syndrome is a rare and somewhat controversial diagnosis.  It was first described by Siegbert Ganser in 1898 and is sometimes called "prison psychosis" because it was first observed in prisoners. With this condition, a person deliberately and consciously acts as if they have a physical or mental illness when they are not really sick. People with Ganser syndrome mimic behavior that is typical of a mental illness, such as schizophrenia

People with factitious disorders act this way because of an inner need to be seen as ill or injured -- not to achieve a clear benefit, such as financial gain. They are even willing to undergo painful or risky tests and operations in order to obtain the sympathy and special attention given to people who are truly ill. Factitious disorders are technically considered mental illnesses because they are associated with severe emotional difficulties.

People with Ganser syndrome have short-term episodes of odd behavior similar to that shown by people with other serious mental illnesses. The person may appear confused, make absurd statements, and report hallucinations such as the experience of sensing things that are not there or hearing voices. A classic symptom of Ganser syndrome is vorbeireden. This is when the person gives nonsense answers to simple questions. In addition, a person with this condition may report physical problems such as an inability to move part of the body, called "hysterical paralysis." Loss of memory (amnesia) of the events that occurred during an episode is common.

Little is known about this unusual disorder, but it is believed to be a reaction to extreme stress. There are also physical problems that may cause the symptoms of Ganser syndrome such as alcoholism, head injury, and stroke.

Most people with this condition also have a personality disorder, usually antisocial personality disorder or histrionic personality disorder. Antisocial personality disorder is characterized by irresponsible and aggressive behavior that often involves a disregard for others and an inability to abide by society's rules. People with antisocial personality disorder are sometimes referred to as "sociopaths" or "psychopaths." For people with histrionic personality disorder, their self-esteem depends on the approval of others and does not arise from a true feeling of self-worth. They have an overwhelming desire to be noticed, and often behave dramatically or inappropriately to get attention.

Ganser syndrome is very rare. It is more common in men than in women and most often occurs in the late teens and early adult years.

Diagnosing Ganser syndrome is challenging. Doctors must rule out any possible physical problems, such as stroke or head injury, or other psychological conditions as the cause of the symptoms before considering a diagnosis of Ganser syndrome.

If the doctor finds no physical reason for the symptoms, they may refer the person to a psychiatrist or psychologist, mental health professionals who are specially trained to diagnose and treat mental illnesses. Psychiatrists and psychologists use specially designed interviews and assessment tools to evaluate a person for psychiatric conditions. The doctor bases their diagnosis on the use of these tools as well as the exclusion of other physical or mental illnesses and their observation of the patient's attitude and behavior.

 It is difficult to predict whether and when symptoms of Ganser syndrome are likely to go away. This is partly because people with Ganser Syndrome often present with fake symptoms not just simply in response to a stressful event, but because the condition often reflects someone's limited ability to cope effectively with stresses when they occur.

Supportive psychotherapy (a type of counseling), and monitoring for safety and a return of symptoms are the main treatments for Ganser syndrome. Medication usually is not generally used, unless the person also suffers from depressionanxiety, or psychosis.

It is difficult to predict whether and when symptoms of Ganser syndrome are likely to go away. The likelihood for recovery from Ganser syndrome can vary greatly depending on whether the symptoms arose suddenly in response to a stressful experience or reflect a more long-term pattern.

There is no known way to prevent this condition.