JMIR Publications

ABSTRACT

Background:

Persecutory delusions have long mirrored prevailing cultural and technological concerns. Beliefs involving implanted devices, internet surveillance, hacked smartphones, algorithmic targeting, and artificial intelligence-mediated control are increasingly visible in contemporary psychosis. However, we identified no prior review dedicated specifically to synthesising technology-themed delusional content across historical and contemporary clinical contexts.

Objective:

This narrative review aimed to trace the historical evolution of technology-themed delusions, characterise their contemporary clinical phenomenology, examine relevant neurocognitive and sociocultural mechanisms, and discuss implications for psychiatric assessment and intervention.

Methods:

PubMed/MEDLINE, Scopus, and APA PsycInfo were searched without date restrictions, supplemented by backward citation tracking and targeted identification of historical primary sources. Eligible sources included original research, case reports and case series, reviews, and relevant conceptual or historical publications addressing delusional content involving technology. A narrative synthesis approach informed by the Scale for the Assessment of Narrative Review Articles framework was used. Full database search strings are reported in Multimedia Appendix 1. The final search was completed on May 1, 2026.

Results:

Forty-one sources were included in the narrative synthesis, comprising 11 case reports or case series, 12 empirical observational studies, 7 reviews, and 11 historical or conceptual sources. Technology-themed delusions appeared as pathoplastic variants of enduring persecutory, control, and referential motifs, clustering into five overlapping categories: surveillance and hacking beliefs, implant and control delusions, Truman Show-type broadcast phenomena, social media-specific referential ideas, and emerging algorithmic and artificial intelligence-mediated themes. Cognitive models of persecutory ideation, the aberrant salience hypothesis, technological unfamiliarity, digital immersion, and wider sociocultural narratives all appeared relevant to these presentations. Pandemic-era conspiracy material, including 5G and vaccine-microchip narratives, further illustrated how culturally available technological explanations may scaffold delusional elaboration in vulnerable individuals.

Conclusions:

Technology-themed delusions represent contemporary expressions of enduring delusional motifs shaped by digital culture. Their assessment requires psychiatric expertise combined with sufficient technological literacy to distinguish proportionate privacy concerns, overvalued conspiracy beliefs, and fixed delusional conviction. Future research should use prospective cohort designs, cross-cultural comparisons, and targeted evaluation of cognitive-behavioural and digital-literacy-informed interventions, while monitoring emerging artificial intelligence-mediated phenomena.