Psychiatrists detail chilling case of Internet-induced erotomania

In an increasingly interconnected world through the wonders of the Internet, a case study published in BMC Psychiatry shines a light on a darker side of digital interaction: online romance fraud that induces erotomania, a rare delusional disorder.

Erotomania, or Clrambaults syndrome, manifests as a persistent, delusional belief that an individual, usually of higher social status, is in love with the person experiencing the delusion, despite little or no interaction between the two. This condition, recognized in major psychiatric classifications such as 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 doctors and scholars alike, with its roots going back to the musings of Hippocrates and the detailed studies of the French psychiatrist Gatan de Clrambault in the early 20th century.

A patient’s journey to 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, which led her down a path of psychological turmoil and near-tragedy. Her journey to this delusional state began innocently enough, with her expressing admiration for a musician’s work on social media. This admiration quickly turned into an intense emotional involvement, fueled by fraudulent interactions with someone she believed to be the musician herself.

Over the course of more than a year, the scammer, hiding behind the identity of the musician, cultivated a deep emotional connection with the patient. Through clever manipulation and deception, the scammer convinced her of his romantic interest, leading her to undertake personal transformations and even financial sacrifices in the name of love. The situation escalated into family strife and a serious suicide attempt when the financial demands of the scam 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 abandoned, her life was marked by isolation, a depressed mood, and a lack of meaningful relationships outside of her marriage. His mental state, compounded by various health problems and mild cognitive impairment, created fertile ground for the seeds of delusional beliefs to take root.

On admission to a psychiatric ward following his suicide attempt, a comprehensive assessment revealed the complex interplay of cognitive, emotional and psychological factors underpinning his condition. The diagnosis of erotomaniac deception, induced by online romance fraud and exacerbated by her pre-existing vulnerabilities, presented a challenging treatment scenario.

The road to recovery

The patient’s treatment approach 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 empathic, accepting and supportive therapeutic interactions, which also sought to resolve marital conflicts exacerbated by the scam.

The case underlines the crucial importance of early recognition and intervention in cases of Internet-induced erotomania. With the widespread reach of digital communication and the sophistication of online fraud, people with existing vulnerabilities are at greater risk of falling into these deceptive practices, with potentially devastating psychological consequences.

Lessons learned and the way forward

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

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

“These may include dependent personality traits, unrealistic idealization, impaired cognitive function that affects situational awareness, reduced problem-solving skills, compromised mentalizing skills, experiences of loneliness and isolation, and relationship or family problems.”

Nasri Alotti, Peter Osvath, Tamas Tenyi, and Viktor Voros wrote the case study “Erotomania Induced by Online Romance Fraud: A New Form of Clrambaults Syndrome.”