Delusional Parasitosis Facilitated by Web-Based Dissemination

In certain psychoanalytic circles, the co-delusion of two psychotics is known as a delire a deux. Obviously, the internets would change the parameters of such a phenomena, which, as one might imagine, can’t usually be sustained outside small, insular groups (a mother and daughter, elderly companions or siblings, etc):

Many scholars have anticipated and foreseen thepositive effect of the Internet on medicine. … However,one potential negative consequence is the dissemination of informationwith minimal or no supporting evidence that is incorrectly portrayedas factual. We report the case of an individual who experienceddelusional ideation via the Internet.

“Mr. M” was a 57-year-old Caucasian man who presented at a detoxificationcenter for crack cocaine dependence and schizophrenia markedby persistent auditory hallucinations and paranoid delusions.On assessment, the patient had patches of erythematous skinin his nose and on his right ear, forehead, and right leg. Theseerythematous patches had been present for 3 to 4 years. A dermatologisthad diagnosed the lesions as a delusion of parasitosis. Thepatient strongly disagreed with this diagnosis and felt thatthe lesions were caused by a parasite. He stated that he hadobtained information regarding his condition from the Internetand that the condition was called Morgellons. Our clinical teamsearched the Internet and found results under “Morgellons.”

In 2002, the Morgellons Research Foundation was founded as apersonal initiative by a family who claimed that their 2-year-oldson had a dermatological condition that many physicians wereunable to diagnose. The Morgellons Research Foundation namedthe unknown condition “Morgellons disease” and launched a concertedeffort to achieve recognition of “Morgellons” as a dermatologicalentity of infectious cause, creating a website complete withwritten descriptions and images of skin as well as microscopyimages. Over the course of the years, thousands of people havevisited the Morgellons Research Foundation website, and massmedia coverage has amplified its diffusion (2). Today, the websiteclaims that more than 12,000 families affected by Morgellonsare registered with the foundation, and self-accounts of affectedindividuals are overflowing (3). Furthermore, the foundation—throughits website—has lobbied the Center for Disease Controlto fund an epidemiological study of the condition, which isan unprecedented endeavor (4). The foundation’s effortsand claims are in contrast to the most common clinical perceptionof the illness, since current medical opinion considers thephenomenon to be delusional parasitosis (2).

One can imagine that the cultural-embeddedness of beliefs produce and sustain certain pathological structures, but the idea that instead of the instigation of psychosis, shared beliefs serve to augment a psychotic community is fascinating. Luckily, these “scientists” don’t skirt the whole cultural and religions questions posed by the:

Aside from exemplifying that the Internet can be a misleadingsource of information, the situation we described demonstratesthe challenge that some online communities represent to traditionaldiagnostic criteria, i.e., that a belief is not considered delusionalif it is accepted by other members of an individual’sculture or subculture. Although this may be appropriate in thecontext of spiritual or religious beliefs, the scenario in whicha widely held belief is accepted as plausible simply becausemany people ascribe to it requires a revised conceptualizationin our current era. That is, Internet technology may facilitatethe dissemination of bizarre beliefs on a much wider scale thanever before.

Glad we answered the cultural relativism question, at least.

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