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 Table of Contents 
CASE REPORT
Year : 2019  |  Volume : 8  |  Issue : 8  |  Page : 2738-2740  

Social media smartphone app and psychopathology – A case report


1 Department of Community and Family Medicine, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
2 Department of Psychiatry, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India

Date of Submission26-May-2019
Date of Decision26-May-2019
Date of Acceptance17-Jun-2019
Date of Web Publication28-Aug-2019

Correspondence Address:
Dr. Santosh Kumar
Department of Community and Family Medicine, All India Institute of Medical Sciences, Rishikesh, Uttarakhand
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jfmpc.jfmpc_421_19

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  Abstract 


Thought circulation in social media has always been contributed to psychological morbidity among youth. Although social media smartphone makes a comfort communication among generation it is also responsible for causing psychopathology among youth by circulating video depicting violent scene. The symptoms are often severe and persistent enough to have a significant impact on the person's day-to-day life. The purpose of this case report is to study the impact and consequences of social media (WhatsApp) on the mental health and stability among younger generation. A 30-year-old male patient presented at Family Medicine outpatient department with phobic and anxiety symptoms after witnessing a car accident in WhatsApp video which shows transaction of human body. His clinical presentation, management approach, and details of treatment are presented.

Keywords: Anxiety disorder, mental health, smartphone, unspecified phobic anxiety disorder


How to cite this article:
Kumar S, Natrajan K, Bhadoria AS, Das A. Social media smartphone app and psychopathology – A case report. J Family Med Prim Care 2019;8:2738-40

How to cite this URL:
Kumar S, Natrajan K, Bhadoria AS, Das A. Social media smartphone app and psychopathology – A case report. J Family Med Prim Care [serial online] 2019 [cited 2019 Nov 20];8:2738-40. Available from: http://www.jfmpc.com/text.asp?2019/8/8/2738/265582




  Introduction Top


Social media is defined as “forms of electronic communication through which users create online communities to share information, personal messages, videos and ideas.”[1] It includes websites such as Facebook, WhatsApp, Twitter, and MySpace, online gaming, virtual worlds like YouTube, blogs, Sims, and so on, which allows repeated and constant interaction mostly among younger generation. Social media has advantages by having a larger support network, being able to socialize, deaddiction programs, and national program implementation, while depression, addiction, psychosis, insomnia, cyber bulling, and many more are the disadvantages of it.[2],[3],[4],[5]

As per the classification of ICD-10, F40.9 phobia is a type of anxiety disorder which is a strong, irrational fear of something which possesses little or no actual danger. People with phobia may experience panic and fear, rapid heartbeat, shortness of breath, trembling, and a strong desire to get away. Anxiety disorder is characterized by intense, unrealistic persistent, and irrational fear of an object, activity, or situation that the individual feels compelled to avoid that. This has been grouply defined as unspecified phobic anxiety disorder.[6] Though, WhatsApp being the advancing technology among youth for easy communication, simultaneous circulation of inappropriate (threatening/violent) videos through WhatsApp creates an impact on mental health further affecting the psychosocial quality of life. As in previous studies WhatsApp usage among adolescents and youth have reported various impact on mental health.[7],[8] In our routine outpatient department (OPD), we were constantly being encountered with psychopathological characters contributed by social media among smartphone users among adolescents and youth such as anxiety disorder, obsessive compulsive disorder, and mood disorder driven our attention towards its impact on mental health.


  Case History Top


A male patient age 30 years presented to Family Medicine OPD with complaints of palpitation, chest discomfort, sweating, tremors, depressive mood, anxiousness, and insomnia. One year ago, he had witnessed a video depicting a violent scene in WhatsApp video showing transection of human body in a car accident. He got fearful even from small disputes with his wife or children. He neither had hallucinations nor delusions. He was illiterate, married, barber by occupation, from a nuclear family belonging to upper lower socioeconomic class with no previous significant medical history or any history of addiction.


  Mental State Examination Top


The patient was calm with guarded attitude toward the interviewer. His speech pattern was slow and sparse with low voice. He described his current mood as depressed with thought of early death. His thoughts were centered around that terrifying car accident with fear of death or accident to his family members and he was restricting them to home. He is the only earning member in the family; after this incident he started restricting himself to go to work or travel outside or attending social functions like before which was further affecting their social living. When he tried to move out of house, he had palpitation, chest discomfort, and tremors.

During examination, he had no perceptual disturbances. In the initial 3 months, he was insomniac. He said that he was fearful even from small quarrels with his wife or children but did not have any thought of being killed by them. No manic episodes were observed during this period. He said that he was not controlled by anyone. He had unspecified phobic episodes such as afraid of accidents and does not want to witness any accident after that either in video or in reality. He claimed that it was the first time he came across such a terrifying video on WhatsApp. After this incident, he refused to see WhatsApp videos or even using smartphones. He had a fear that his wife and children may meet similar accident in future.

Neurological examination and his mini-mental score were normal. However, the patient suffered from unspecified phobic anxiety disorder. He reported himself to a hospital in Noida for chest discomfort but did not disclose about his symptoms fully there and got multiple investigations such as liver profile, renal profile, blood count, lipid profile, electrolyte, and thyroid profile done. All were normal and he was referred to a cardiologist where he was evaluated with electrocardiogram and ECHO which was also reported as normal. Angiography was planned for him in a private hospital in Noida. As he was not able to manage financial strain on his hospital expenditure, he came to AIIMS Rishikesh, Family Medicine OPD after getting suggestion from his friend.

Family Medicine in AIIMS Rishikesh is destined and striving for clinical, psychological, and contextual assessment and comprehensive care of every patient coming to the OPD. After thorough history and examination, he was diagnosed with “unspecified phobic anxiety disorder,” and he was started on psychological counselling under Family Medicine context and pharmacotherapy simultaneously. Pharmacotherapy had been initiated with tablet sertraline 25 mg once daily along with tablet clonazepam 0.5 mg and propranolol 20 mg once daily. Psychological counselling included cognitive behavioral therapy and humanistic therapy. Cognitive behavioral therapy focused on thoughts, feelings, and behavior of the person and desensitization, cognitive reframing, and restructuring. Humanistic approach has established in creating a foundation of respect for the patient and mutual acceptance of significance of their experiences. His cultural values and freedom to exercise has been respected.

His symptoms of palpitations, tremor, sweating, chest discomfort, and insomnia improved within 1 week of treatment initiation. Further, he was maintained with tablet sertraline 25 mg once daily and tablet clonazepam 0.5 mg with propranolol 20 mg SOS for the next 15 days. Pharmacotherapy had been tapered after 15 days and stopped after a month. The patient was kept under regular counselling and family therapy, and family members were also counselled for emotional and social support. He showed dramatic improvement following this synergistic treatment of psychotherapy with pharmacotherapy. The patient's anxiety symptoms and fear for smartphone and terrifying events have improved. However, he still got strong concern for the well-being of his children if he would die early, for which he is being counseled regularly.


  Discussion Top


Excessive use of smartphone app and its impact makes them restricted to the app by losing interest in the real world and their emotions to other things. This case study reveals an association between watching traumatic events on social media and unspecified phobic anxiety disorder. There is a link between watching videos or news related to traumatic events such as terrifying accidents and terrorist attacks and stress, anxiety symptoms, and its effect on people's mental health and well-being. Humanistic and cognitive behavioral therapies have an effect in improving symptoms of anxiety and phobia.[9],[10],[11],[12] But in our study humanistic and cognitive behavioral and family therapies have a synergistic effect in improving symptoms of anxiety and phobia with simultaneous use of pharmacotherapy. With advancement in media technology, there is a strong need to scientifically investigate the impact of social media on mental and social well-being of humans.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

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Pfefferbaum B, Newman E, Nelson SD, Nitiéma P, Pfefferbaum RL, Rahman A, et al. Disaster media coverage and psychological outcomes: Descriptive findings in the extant research. Curr Psychiatry Rep 2014;16:464.   Back to cited text no. 1
    
2.
Mattar M, Blatchford T, Alao A. Facing the truth about social media: Psychopathology among social media users. Ann Psychiatry Ment Health 2016;4:1070.  Back to cited text no. 2
    
3.
Durbano F, Marchesi B. Disorders. IntechOpen. Available from: https://www.intechopen.com/books/new-developments-in-anxiety-disorders/impact-of-social-media-on-social-anxiety-a-systematic-review. [Last accessed on 2019 Apr 29].  Back to cited text no. 3
    
4.
Strickland A. Exploring the Effects of Social Media Use on the Mental Health of Young Adults. HIM 1990-2015; 2014. p. 1684. Available from: http://stars.library.ucf.edu/honorstheses1990-2015/1684. [Last accessed on 2019 Apr 29].  Back to cited text no. 4
    
5.
Pantic I. Online social networking and mental health. Cyberpsych Beh Soc N 2014;17:652-7.   Back to cited text no. 5
    
6.
World Health Organization. World Health Organization; Available from: https://icd.who.int/browse10/2015/en#F40.0. [Last accessed on 2019 Apr 29].  Back to cited text no. 6
    
7.
Faye AD, Gawande S, Tadke R, Kirpekar VC, Bhave SH. WhatsApp addiction and borderline personality disorder: A new therapeutic challenge. Indian J Psychiatry 2016;58:235-7.  Back to cited text no. 7
[PUBMED]  [Full text]  
8.
Clement Babu P, Ravi Kumar P. Effects of Whatsapp on psychological, physical and personal self: A health perspective. Int J Creative Res Thoughts 2018;6:235-9.  Back to cited text no. 8
    
9.
Burns RB. Humanistic-existential therapies – An overview. Counselling and Therapy; 1983. p. 135-9.   Back to cited text no. 9
    
10.
Beck AT, Emery G, Greenberg RL. Anxiety Disorders and Phobias: A Cognitive Perspective. New York, NY: Basic Books; 2005.  Back to cited text no. 10
    
11.
Hofmann SG, Smits JA. Cognitive-behavioral therapy for adult anxiety disorders: A meta-analysis of randomized placebo-controlled trials. J Clin Psychiatry 2008;69:621-32.  Back to cited text no. 11
    
12.
Salkovskis PM. The importance of behaviour in the maintenance of anxiety and panic: A cognitive account. Behav Psychother 1991;19:6-19.  Back to cited text no. 12
    




 

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   Mental State Exa...
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