Study: Prolonged Internet use may cause psychotic episodes

Early research being conducted by the Clalit Health Maintenance Organization points to a possible connection between unrestricted Internet use and the occurrence of psychotic episodes.

At a conference today at Shalvata Mental Health Center in Hod Hasharon, researchers will present three cases of individuals who experienced psychotic episodes in the wake of intensive Web surfing that included the development of a close online relationship with another person.

All three subjects are women between the ages of 30 and 50 with no significant psychiatric history. Two of them had no previous history of psychological or psychiatric treatment, while one had been treated for anxiety in the past.

All three had experienced an unsatisfactory intimate relationship in the past and developed a dependent relationship with a man over the Internet, without ever meeting him face-to-face.

All three required psychiatric care in the past year after undergoing an uncontrollable psychotic episode accompanied by delusions and hallucinations. One of the women was referred to the emergency room of a psychiatric hospital, while two sought treatment in a clinic. All three required antipsychotic drugs to halt the episodes and all three returned to full function afterward.

"These women turned to the Internet as an emotional refuge, for emotional warmth. Their psychotic episode was expressed as delusions, cognitive disability, anxiety and withdrawal and impairment to their daily functioning. There was a distortion in their comprehension of reality," said Dr. Uri Nitzan, a psychiatrist with Clalit who is one of the researchers.

All three women spent many hours a day - especially at night - on the Internet.

The subjects' psychoses included a total disconnection from reality, and in the case of one of the women also involved tactile hallucinations; she imagined that she could feel the man with whom she was having a "virtual relationship" touching her.

Nitzan said that while a causal relationship cannot be established between Internet use and psychotic episodes, the women in the study told the researchers that their condition developed in parallel with their increasing involvement in their Internet relationships.

While Internet-related psychosis has not yet appeared in scientific literature, there is a growing body of research on Internet addiction and on the appearance of Internet delusions in individuals with a history of mental disorders.

"There are descriptions of patients who have developed delusions inspired by computer software or hardware, such as one man who believes that someone is trying to poison his fingers through his computer keyboard or to implant certain thoughts in his mind," Nitzan said.

The researchers point to unique features of interpersonal interaction on the Internet that could lend themselves to psychotic episodes, especially in the case of unrestricted use of the Internet. Nitzan singled out e-mail, chat applications and certain Facebook applications, noting that "the transition from daily reality to virtual reality is a transition of consciousness to a different space that is neither reality nor outside of reality, and is sometimes used as a substitute for or refuge from reality."

Nitzan pointed out the potential for misunderstandings as a result of text-based Internet interactions, which lack the body language and the nuances of face-to-face contact.

In addition, he noted, "virtual communication also undermines the measurement of both space and time, since someone who lives next door and someone who lives in a distant country are equally close."

The distortion of space created by the Internet has been called "nothing space," a space that, Nitzan says, "blurs the distinction between the parties. A game of creating identities is born that threatens to undermine one's self-identity and to penetrate the boundary between an individual and his or her environment."

Nitzan said that continued research of the link between Internet use and mental disorders is necessary, along with increased awareness among mental patients of the possible dangers of unrestricted Internet use.

	A study points to a possible connection between Internet use and psychosis.
	Photo by: (AP)