Internet diagnoses interfere with treatment, says forensic psychiatrist

Conspiracy theories like the Illuminati or “gangstalking” can sound like punchlines to bad jokes for many people, but for psychiatric patients they can feel real — and threatening.

Irrational fears of surveillance or government control are common among individuals who experience delusional disorder, said Dr. James Brad McConville, an assistant clinical professor of psychiatry and forensic psychiatry in the Tulane University School of Medicine.

McConville lectured on “Cyberinsanity: How the Internet Works Against Psychiatry and Propagates Psychotic Illness” for School of Medicine residents and faculty last week.

“We’re talking about a potentially destructive source of information for somebody who’s uniquely susceptible to that information.”

Dr. James Brad McConville

Delusional disorders, such as demonic possession or even shrinking body parts, have been recorded for centuries, McConville said.

“In the modern day, there are more delusions that involve technology and government involvement,” he added.

Whereas 30 years ago an individual might talk to a friend or doctor about irrational thoughts, the internet makes it easier for delusional people to use social media or web communities to find like-minded individuals, who may tell them their family or physician is “part of” a conspiracy against them and discourage them from seeking treatment.

“We’re talking about a potentially destructive source of information for somebody who’s uniquely susceptible to that information,” McConville said.

“Over time, delusional ideas can solidify and become delusional memories, refractory to treatment. Once a person has been holding a delusional thought for long enough, in our experience, they become difficult to medicate.”

As a forensic psychiatrist, McConville sees people from the court system whose mental stability is questioned.

He called on the audience to consider the role that the internet plays in psychiatry, especially as people seek to self-diagnose.

“Do we have enough influence, do we have enough power in our diagnoses and in our science to combat all the non-science from the internet?” he asked. “Are psychiatrists and other mental health professionals working to combat destructive misinformation?”

McConville’s lecture was part of the Grand Rounds speaker series sponsored by the Department of Psychiatry.