Delusions and Fixed Beliefs in the Age of the Internet: When Do Conspiracy Theories Become Illness?

The internet, especially in the form of social media, provides an avenue for dissemination of unusual and fixed ideas. Recently, the role of conspiracy theories (CTs) in perpetuating myths about the Coronavirus disease (COVID-19) has attracted the attention of mental health practitioners. While extreme CTs may carry some similarities to delusions and may occur in similar socioeconomic groups, some distinctions can be made in the clinical setting. There is little evidence that social media use or gaming with virtual-reality tools on the internet cause psychotic illness, although the internet does promote CTs. Nevertheless, individuals with psychotic illness are overrepresented among internet users and this may allow for greater exposure to unusual beliefs. Future immersive experiences on the internet such as virtual reality and the metaverse may present challenges for people at risk of developing fixed beliefs, but research will be needed on this subject. [Psychiatr Ann. 2023;53(4):171–174.]