A case of Ganser's state presenting as a dementia syndrome

We report an atypical case of Ganser's syndrome in a 54-year-old male patient. The following symptoms which include approximate answers perceptual disturbances and dissociative mechanisms were observed over 7 years, improved during hospitalization, but reappeared just before the patient's discharge. The extremely long presence and bizarre manifestation of symptoms, the course of the disorder and the patient's premorbid high intelligence level point to an unusual presentation of this case. Following the concept of hysteria and dissociation, we discuss its diagnosis within the scope of the DSM-III-R, DSM-IV and ICD-10 classification of Dissociative Disorders. Problems in the differential diagnosis which result from an increasing awareness of Dissociative Disorders are outlined.