The “Truman Show” delusion: Psychosis in the global village

Introduction. We report a novel delusion, primarily persecutory in form, in which the patient believes that he is being filmed, and that the films are being broadcast for the entertainment of others.

Methods. We describe a series of patients who presented with a delusional system according to which they were the subjects of something akin to a reality television show that was broadcasting their daily life for the entertainment of others. We then address three questions, the first concerning how to characterise the delusion, the second concerning the role of culture in delusion, and the third concerning the implications of cultural studies of delusion for the cognitive theory of delusion.

Results. Delusions are both variable and stable: Particular delusional ideas are sensitive to culture, but the broad categories of delusion are stable both across time and culture. This stability has implications for the form a cognitive theory of delusion can take.

Conclusions. Cultural studies of delusion have important contributions to make to the cognitive theory of delusion.

Keywords

• Culture,
• Delusion,
• Grandiosity,
• Ideas of reference,
• Persecution,
• Reality television