In our recent information-oriented society, will the Internet take the place of televisions in delusions? Delusions regarding the Internet have been reported rarely (1,2). We report the case of a patient with a schizoaffective disorder and a delusion involving the Internet that lasted for 2 years.

A 57-year-old woman developed a hypomanic state in which she wasted money, bought expensive Buddhist items, and took lessons in traditional female accomplishments that included flower arranging, the tea ceremony, and calligraphy. Simultaneously, she experienced auditory hallucinations. She complained that she heard voices on radio waves emanating from a satellite through the Internet. She explained her squandering of money by stating that voices through the Internet commanded her to do so. The voices, for example, told her not to buy useless things but to buy what she wanted. At other times, the voices told her that she should be more feminine, leading her to take lessons in the arts. She did not, however, have any experience with the Internet, nor did she have a personal computer. Two years later, her unbearable waste of money required hospitalization, with a diagnosis

of schizoaffective disorder. She explained that a world economic organization in a spaceship orbiting Earth made 2 men use radio waves through the Internet to command her to do things. She was medicated with bromperidol 6 mg daily to relieve her of her manic state, but at the time of discharge she continued to have auditory hallucinations “from the Internet” that disappeared 6 months later.

The Internet is a worldwide communication tool that is open to the general public. It has many characteristics that are compatible with such abnormal schizophrenic experiences as thought-broadcasting and worldwide delusional systems. Thus, the Internet seems to be incorporated easily into the delusional systems of patients with schizophrenia. Nonetheless, patients rarely have “Internet delusions.” In our clinical experience, a few patients with schizophrenia have described “Internet delusions,” but only transiently. One woman with schizophrenia believed, during a short period of deterioration in her illness, that embarrassing photographs of her were being broadcast on the Internet. Similarly, at the onset of his illness, a man with schizophrenia believed that he was

known by the public after sending e-mail for the first time. Probably, patients do not find the Internet to be  as “virtually real” as television. E-mail, however, bears a close resemblance to written letters, and there is not much difference between home pages and magazines. In reality, the Internet does not have much supernatural potential, but our patient did not have any computer experience and did not have a proper understanding of it. Previously reported cases (1,2) also had little computer experience. Apparently, the more that patients are acquainted with the Internet, the less it is incorporated into their delusional systems. In our patient, the Internet was probably no more than a medium for a pathological experience with a megalomanic character.

References

1. Tan S, Shea C, Kopala L. Paranoid schizophrenia with delusions regarding the Internet [letter]. J Psychiatry Neurosci 1997;22:143.
2. Catalano G, Catalano MC, Embi CS, Frankel RL. Delusions about the Internet. South Med J 1999;92: 609–10.

Toshiyuki Kobayashi, MD, PhD
Yoshifumi Okada, MD
Koich Nisijima, MD, PhD
Satoshi Kato, MD, PhD
Tochigi, Japan