The psychopathological implications of the Internet are slowly being revealed as its use becomes increasingly common. This papers aim is to call attention to computer mediated communication (CMC), such as Facebook or chats, and alert to its possible relation to psychosis.
We describe three individuals, with no prior major psychiatric disorder, who presented for psychiatric treatment, due to psychotic symptoms which appeared de novo while they were immersed in CMC. All three patients pointed to the contribution of specific CMC features to the gradual emergence of their psychotic symptoms. They described a 'hyperpersonal' relationship with a stranger, mistrust of the aims and identity of the other party, blurred self boundaries, misinterpretation of information, and undesirable personal exposure in cyberspace. The patients had little prior experience with computers or the Internet, and their vulnerability was intensified due to difficulties in deciphering the meaning of various elements of CMC and in managing its technical aspects.
The cases we present support the assumption that unique features of CMC might contribute to the formation of psychotic experiences. The use of the Internet is vast, and, as such, we propose that medical staff members might consider routinely questioning patients about their use of it, especially CMC.
Shalvata Mental Health Care Center, Hod Hasharon, Israel, affiliated to the Sackler School of Medicine, Tel Aviv University, Ramat Aviv, Israel. firstname.lastname@example.org