Psychiatrists detail a harrowing case of internet-induced erotomania

In a world increasingly interconnected through the wonders of the internet, a case study published in BMC Psychiatry sheds light on a darker facet of digital interaction: online romance fraud inducing erotomania, a rare delusional disorder.

Erotomania, or de Clérambault’s syndrome, manifests as a persistent, delusional belief that an individual, typically of higher social status, is in love with the person experiencing the delusion, despite little to no interaction between the two. This condition, recognized in major psychiatric classifications such as the ICD-11 and DSM-5-TR, reflects a profound misinterpretation of social cues, leading to a one-sided and often obsessive pursuit of the perceived admirer.

This syndrome has fascinated clinicians and scholars alike, with its roots traced back to the musings of Hippocrates and the detailed studies of French psychiatrist Gaëtan de Clérambault in the early 20th century.

A Patient’s Journey into Delusional Love

The subject of this case study is a 70-year-old married woman from Hungary who fell victim to an online romance scam, leading her down a path of psychological turmoil and near tragedy. Her journey into this delusional state began innocently enough, with her expressing admiration for a musician’s work on social media. This admiration quickly escalated into an intense emotional involvement, fueled by fraudulent interactions with someone she believed to be the musician himself.

Over the course of more than a year, the scammer, hiding behind the musician’s identity, cultivated a deep emotional connection with the patient. Through clever manipulation and deceit, the fraudster convinced her of his romantic interest, leading her to undertake personal transformations and even financial sacrifices in the name of love. The situation spiraled into family conflicts and a serious suicide attempt when the scam’s financial demands became overwhelming and her husband intervened.

The patient’s background painted a picture of vulnerability ripe for exploitation. A retired cook with a history of feeling neglected, her life was marked by isolation, a depressive mood, and a lack of significant relationships outside of her marriage. Her mental state, exacerbated by various health issues and a mild cognitive impairment, created a fertile ground for the seeds of delusional belief to take root.

Upon admission to a psychiatric department following her suicide attempt, a comprehensive evaluation revealed the complex interplay of cognitive, emotional, and psychological factors underpinning her condition. The diagnosis of erotomanic delusion, induced by the online romance fraud and compounded by her preexisting vulnerabilities, presented a challenging treatment scenario.

The Path to Recovery

The treatment approach for the patient was multifaceted, combining psychopharmacological intervention with individual and group therapy. Central to her recovery was the gradual realization of the fraudulent nature of the online relationship and the processing of the associated emotional trauma. This process was supported by empathetic, accepting, and supportive therapeutic interactions, which also aimed to resolve the marital conflicts exacerbated by the scam.

The case underscores the paramount importance of early recognition and intervention in cases of internet-induced erotomania. With the pervasive reach of digital communication and the sophistication of online fraud, individuals with existing vulnerabilities are at heightened risk of falling prey to such deceptive practices, with potentially devastating psychological consequences.

Lessons Learned and the Road Ahead

This case highlights the need for increased awareness and understanding of the psychological risks associated with online romance fraud, particularly among those with preexisting mental health conditions.

“The presented case highlights the susceptibility of individuals with mental disorders to developing erotomanic delusions in the context of online romance fraud,” the researchers concluded. “It is crucial to monitor the online activity of such patients, particularly those with specific risk factors, as they are more likely to become victims. Identifying personality characteristics and psychopathological symptoms that elevate the risk of victimization is essential.”

“These may include dependent personality traits, unrealistic idealization, cognitive function impairment affecting situational awareness, reduced problem-solving abilities, compromised mentalization skills, experiences of loneliness and isolation, and relationship or family problems.”

The case study, “Induced erotomania by online romance fraud – a novel form of de Clérambault’s syndrome,” was authored by Nasri Alotti, Peter Osvath, Tamas Tenyi, and Viktor Voros.