Indian Journal of Social Psychiatry

LETTER TO EDITOR
Year
: 2020  |  Volume : 36  |  Issue : 1  |  Page : 91--92

WhatsApp as a modality of expression of delusional misinterpretation


Manoj Kumar Sharma1, Santosh K Chaturvedi2,  
1 Department of Clinical Psychology, Service for Healthy Use of Technology Clinic, National Institute of Mental Health and Neuro Sciences (Institute of National Importance), Bengaluru, Karnataka, India
2 Department of Psychiatry, National Institute of Mental Health and Neuro Sciences (Institute of National Importance), Bengaluru, Karnataka, India

Correspondence Address:
Manoj Kumar Sharma
Department of Clinical Psychology, Service for Healthy Use of Technology Clinic, Dr. M. V. Govindaswamy Centre, National Institute of Mental Health and Neuro Sciences (Institute of National Importance), Hosur Road, Bengaluru - 560 029, Karnataka
India




How to cite this article:
Sharma MK, Chaturvedi SK. WhatsApp as a modality of expression of delusional misinterpretation.Indian J Soc Psychiatry 2020;36:91-92


How to cite this URL:
Sharma MK, Chaturvedi SK. WhatsApp as a modality of expression of delusional misinterpretation. Indian J Soc Psychiatry [serial online] 2020 [cited 2020 Aug 10 ];36:91-92
Available from: http://www.indjsp.org/text.asp?2020/36/1/91/280825


Full Text



Sir,

Cyber modalities can also affect the expression and manifestation of psychological conditions. Its role has been seen in an emergence or the magnification of certain personality traits and the manifestation of Twitter-induced psychotic episode.[1],[2] The present case sought consultation at Service for Healthy Use of Technology clinic. It is an India's first tech deaddiction clinic. Mr. X who is a 25-years-old, unmarried, postgraduate male presented with a 6-year history of delusion of persecution and reference, obsessive thought of a sexual nature, and rituals till June 2018. Subsequent to this, Mr. X reported having delusional misinterpretation through WhatsApp. It initially began when Mr. Y who was staying in his neighborhood uploaded a profile picture of himself holding a gun. Mr. X started having the belief that he uploaded the profile picture to threaten or scared him. Mr. Y was tracking him through virtual means, especially WhatsApp, to kill him. He described Mr. Y as being of strong built with long hair and with an intimidating approach.

Mr. X preoccupation with Mr. Y WhatsApp display picture continued for days. He started spending 6–7 h in watching the messages of Mr. Y. He started remaining distressed due to fear of being harmed. He stopped going out of house, showed reduction in interaction with family members, preoccupation about ways to manage Mr. Y, looking or working on strategies to seek legal help, and started showing disturbance in initiation and maintenance of sleep. He was diagnosed with delusional disorder. Clinical interview also revealed presence cognitive and attribution bias for WhatsApp-based misinterpretation. He was advised pharmacological management. Mr. X was psychoeducated for use of technology as well as role of biases in maintenance of complaints. He was given cyber literacy to challenge the belief about WhatsApp-based threat. Behavioral experiment was carried out to help him to enhance his social interaction as well as interaction with others. He was motivated to enhance his involvement in other activities. The sessions were held thrice a day during his 45-day inpatient stay. The improvement was seen in the form increased social interaction, engagement in vocational plan, and decrease in the intensity of misinterpretation attributed to WhatsApp.

The case report documents the role of WhatsApp in enhancing the delusional misinterpretation. The role of Internet can vary considerably in the presentation of psychopathology of delusional belief. It generally covers two themes. The first is the use of the Internet as an explanatory modality for having unusual experiences such as being under thought broadcast, control, or hearing voice. The second theme involves the use of the Internet by people who are thought to be conspiring against the affected person.[3] In the present case, WhatsApp was the media through which the delusion of misinterpretation manifested. Researchers have also proposed to include Internet delusion as “delusional disorder with delusional ideas related to the Internet.”[4] There is a need to enhance cyber literacy for mental health issues among treatment seekers as well as collaboration with technology expert to have safe online experience. It also implies the need to treat to any primary psychopathology as well as developing psychoeducational module to bring awareness about digital activity.

Declaration of patient consent

The authors certify that they have obtained all appropriate patient consent forms. In the form, the patient has given his consent for his images and other clinical information to be reported in the journal. The patient understands that his name and initials will not be published and due efforts will be made to conceal identity, but anonymity cannot be guaranteed.

Acknowledgment

This research work was funded by the Research Grant to Dr. Manoj Kumar Sharma from the Department of Health Research, Indian Council of Medical Research, New Delhi, India.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

References

1Aboujaoude E. In: Virtually You: The Dangerous Powers of the E-personality. New York: Norton; 2011.
2Bell V, Grech E, Maiden C, Halligan PW, Ellis HD. 'Internet delusions': A case series and theoretical integration. Psychopathology 2005;38:144-50.
3Catalano G, Catalano MC, Embi CS, Frankel RL. Delusions about the Internet. South Med J 1999;92:609-10.
4Kalbitzer J, Mell T, Bermpohl F, Rapp MA, Heinz A. Twitter psychosis: A rare variation or a distinct syndrome? J Nerv Ment Dis 2014;202:623.