Delivering email directly to the mind

The current issue of the International Journal of Geriatric Psychiatry has a curious letter about a patient who had the delusional belief that emails were being delivered directly to her mind:

Dear Editor

We report the case of an elderly lady with no experience of using a personal computer or internet technology, whose delusional experiences included the direct personal receipt of email.

Ms T, an 84-year old female with a 40-year history of schizoaffective disorder, presented with a delusional belief that something precious and of value ‘for all people’ had been inserted into her body by a doctor in Germany in the 1950s. She had sought medical help because she believed that an abdominal operative procedure would be necessary to remove a “rat and a teddy bear made of diamonds” that she believed had grown within her.

Following admission, she remained highly guarded, distressed and preoccupied with the need of urgent surgery, which she demanded every time she met her medical team. When asked about the origins of this belief and her desire for surgery, she said that she had gained knowledge about this from a friend, whom she had seen last in 1945.

She explained that she received emails from this friend. These arrived in her mind, exactly like electronic mail, but were managed without a computer. Rather than receiving messages in text form, she received what she described as ‘an impression in my mind’, which conveyed an unequivocal meaning to her. She also believed that her friend had some valuable information for the medical team and that he would be able to contact the senior physician by a similar mechanism.

Following 4 weeks of treatment with risperidone 1.0 mg bd her mental state improved to the point where she stopped receiving the emails, gained insight into her primary belief and told us that she was satisfied that surgery was no longer needed.

There have been previous reports of delusions specific equipment components (Schmid-Siegel et al., 2004) and general activity in the internet (Tan et al., 2004). Most reported cases tend to be in young people, often with a particular experience in using the internet (Bell et al., 2005). To our knowledge, there have been no previous reports of the particular delusion of email receipt by the self. Our case shows that internet-based delusions are not restricted to the young or to those familiar with use of the internet.

Dr Malgorzata Raczek
Prof Robert Howard