Ganser syndrome: a case report from Thailand

Ganser syndrome or "syndrome of approximates" is characterized by the patient giving incorrect answers to questions, despite showing an understanding of the questions, clouding of consciousness, perceptual abnormalities and symptoms of somatic conversion. The syndrome has a sudden onset, resolves abruptly, and is followed by subsequent amnesia. It was first described by Sigbert Ganser in 1897. It was earlier described as a hysterical disorder, and debate about its classification continues today. Currently, it is categorized under the rubric of dissociative disorder. Overall, fewer than 50 cases have been reported. The etiology of Ganser syndrome remains unknown. Some precipitating stressors have been reported and in other cases patients have had organic brain syndrome. Hospital admission has been recommended, but treatment with antipsychotic medication is not necessarily advised because the syndrome can resolve without treatment. The prognosis is uncertain. The present report is of a 40-year-old Thai male with symptoms of clouding of consciousness, approximate answers to simple questions, reported auditory hallucinations and somatic delusions. All symptoms resolved within 5 days and the patient had no recollection of the event. Ganser syndrome is still considered a rare psychiatric syndrome requiring further exploration.