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Induced erotomania by online romance fraud - a novel form of de Clérambault’s syndrome

Nasri Alotti ; Peter Osvath ; Tamas Tenyi ; Viktor Voros (2024) — BMC Psychiatry

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DOI: 10.1186/s12888-024-05667-6 (opens in a new tab)

Type:   Journal Article
Country:   Hungary
Tags:   AI-Enabled Fraud, Cognitive Impairment, Cross Cultural, Delusional Disorder, Erotomania, Mental Health, Psychology, Psychotherapy, Romance Scams, Suicide Attempt, Victim Experience
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Synopsis

            
Internet usage and its effects on mental health are widely documented, yet reports on internet-induced erotomania remain scarce. Erotomania is a rare, likely underdiagnosed delusional disorder characterized by the belief that a person of higher socioeconomic status harbors romantic feelings toward the affected individual. The present report examines the psychopathology of erotomanic delusion triggered by online romantic deception in a female patient. Using this case as a central focus, the account highlights novel aspects of erotomania that merit attention and further inquiry. The clinical narrative concerns a 70-year-old married Caucasian woman who has a history of medically controlled persistent depressive disorder for several years. Her condition became more intricate as she became deeply engaged with online profiles depicting a famous musician, ultimately falling prey to an online romance fraud. This distressing episode precipitated the emergence of erotomanic delusions and an accompanying suicide attempt. The patient’s medical history reveals a range of health conditions and a sequence of stressful life events that contributed to her vulnerability. A diagnosis encompassing erotomanic delusional disorder, dysthymia, and mild cognitive impairment with a cerebral vascular background was established. Treatment combined her prior antidepressant with low-dose risperidone and included supportive individual and group psychotherapy. The delusional symptoms entered remission after four weeks, leading to discharge with plans for outpatient follow-up. While some delusional beliefs persisted, their intensity diminished and the patient’s overall functioning improved. This case emphasizes the intricate relationship among mental health status, online behavior, and the consequences of delusional thinking, including suicidal ideation. It underscores the necessity of adopting a comprehensive approach to address such complex psychiatric presentations, integrating pharmacological management, psychotherapy, and consideration of online activities within clinical assessment and care.

          

        
                  

            
Identified Gaps

            
The paper identifies scarce literature on internet-induced erotomania, inadequate attention to psychological hazards of online fraud and its role in erotomania, and limited documentation of online romance fraud's impact on people with mental illness. It also states that the true origins of erotomania remain largely unclear.

          

        
                  

            
Methods

            
Clinical case report of one consenting 70-year-old married woman in Hungary. The authors describe her online romance-fraud experience, psychiatric and medical history, clinical examination, laboratory tests, MRI, MMPI, SCID-5-PD, MMSE, and ACE-III. They diagnosed secondary erotomania in the context of psychiatric and organic conditions and reported treatment with sertraline, low-dose risperidone, supportive and cognitive-behavioral therapy, group therapy, and couple counselling.

          

        
                  

            
Limitations

            
This is a single disclosed clinical case from three patients observed in practice; the other two did not consent to case disclosure. It cannot establish causation or estimate prevalence, risk, or treatment effectiveness. The account relies on clinical interpretation of a complex presentation involving cognitive impairment, dysthymia, vascular changes, chronic illness, isolation, and online fraud.

          

        
                  

            
Future Work

            
Conduct comprehensive investigations of the psychological risks of online fraud and its contribution to erotomania. Research should clarify the relationship between online fraud and emergent erotomania to inform preventive measures and tailored mental-health interventions. The paper also notes a need for controlled clinical trials of therapeutic strategies for primary erotomania and related syndromes.

          

              

    
    

        
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