The Ganser Syndrome


1. The recent literature in English and American journals and psychiatric text-books dealing with a variety of aspects of the Ganser syndrome is reviewed. Consideration of Ganser's three original cases and a number of cases examined by the present writer has led to the following conclusions:

(a) Although the Ganser syndrome is traditionally regarded as an hysterical disorder, the evidence is strongly in support of the opinion that the condition is a psychotic one, occurring either after acute cerebral trauma or in the course of an acute psychotic illness, commonly of a schizophreniform or psychogenic kind.

(b) The basic essential of the condition is a disturbance of consciousness. It is maintained that this symptom separates the Ganser syndrome from hysterical pseudo-dementia, a condition occurring without clouding of consciousness in intellectually dull persons in social difficulties.

(c) Certain similarities between the verbal responses of the Ganser patient, the schizophrenic and the aphasic are discussed. Examples of these similarities are provided by some of the cases described.

(d) The belief that the Ganser syndrome occurs mainly in prisoners and male patients is not supported by the evidence provided by the present and other authors.

(e) It is suggested that a diagnosis of Ganser syndrome should be restricted to patients who, following cerebral trauma or in the course of an acute psychosis, develop clouding of consciousness, with characteristic verbal responses to questions, and whose illness terminates abruptly with subsequent amnesia. In a number of cases hallucinations and conversion symptoms might be detected. However, more commonly only a proportion of the features described by Ganser will be observed. In such cases, a diagnosis of Ganser-like symptoms in the course of a psychotic illness might be more appropriate.