A curiously recursive case of psychosis, reported in the latest issue of Cognitive Neuropsychiatry, about a person who worked on a reality TV show who had the delusion that they were on a reality TV show.
Mr D. was working on a reality television show when he was hospitalised after causing a public disturbance. While working on the production of the show, he came to believe that he was the one who was actually being broadcast: ‘‘I thought I was a secret contestant on a reality show. I thought I was being filmed. I was convinced I was a contestant and later the TV show would reveal me.’’ He believed his thoughts were being controlled by a film crew paid for by his family. During the 2 weeks prior to admission, he experienced decreased sleep, pressured speech, irritability, paranoia, and hyperreligiosity. The patient carried a diagnosis of bipolar disorder and had had two previous hospitalisations for manic episodes.
The case is from a paper that reports several cases of what the authors call the ‘Truman Show delusion’ where a person believes that they are being featured on a TV show about their life, as in the film of the same name.
Sadly, the article is locked behind a paywall, as it contains a fantastic discussion of how culture and psychosis interact.
Link to locked academic paper.
Mind Hacks 
good to read this article. i, myself, years and years ago, decided that in order to control myself (I was diagnosed as a schizophrenic) I believe everyday that everything I do is recorded. (This is confirmed in the Bible.) I was so terrified of making any “error in judgement” that eventually I now, for many years, am able to be comfortable. I know I am fooling myself, but in reality nowadays, with ccv cameras and everybody having some kind of recording device, it’s not quite an unreality to watch what one says and does. It helped me to be the best person I can be and to make sure that I was able to pre-judge any action or wording I was about to do or say to avoid “making a fool out of myself”. It comes down to “watching myself”. And now with the www included in my daily living, I am glad that I was able to “foresee” “living under a microscope” and thereby adapting my lifestyle so that, under any scrutiny – from wherever – I am not embarrassed. Yeah, it’s weird, but it doesn’t infringe on anybody and it has helped me to observe myself and develop an amicable disposition.
I think this sort of delusion must be getting fairly common given the popularity of reality tv and the rise of ubiquitous surveillance (CCTV, dragnet phone and internet monitoring and so on). I’ve been prone to it myself, despite not having a bona fide psychotic illness nor ever watching reality tv; I’m just so, so, so anxious I go a bit insane occasionally! Heh.
This guy was bipolar with mania, but there’ve got to be other cases of people involved with reality shows or surveillance (like camera operators in the UK) developing related delusions. I’d love to hear their stories.
The linked paper appears to be free to access and download now: http://www.tandfonline.com/doi/full/10.1080/13546805.2012.666113