Nicholas Marzano believes he's the subject of a secret reality show, and everyone in his town of Hillside, Illinois is in on it. He's suing HBO in federal court for, in his words, "filming and broadcasting a hidden camera reality show depicting the day-to-day activities of plaintiff" without his consent. His suit, filed in April, alleges that HBO has hidden cameras throughout his home, installed controlling devices in his car, enlisted the help of local police, and recruited actors to portray "attorneys, government and law enforcement officials, physicians, employers, prospective employers, family, friends, neighbors, and co-workers," all so that their show about his life can continue. Marzano also says HBO is keeping him from getting a job or paying his bills, so that he will be forced to remain on the show.

He appears to be a perfect example of what psychiatrist brothers Joel and Ian Gold describe, in a paper published this week in the journal Cognitive Neuropsychiatry, as "Truman Show" delusion — sufferers believe they are "the 'star' of a reality television show secretly broadcasting their daily life, much like the main character in Peter Weir’s film The Truman Show." Between the movie's 1998 release and 2006, they saw five patients with the delusion, and news reports from around the world since then have turned up even more disturbing cases. With the increasing popularity of YouTube and reality TV, the Golds think the disorder is on the rise. "Truman Show" delusion may be the early 21st century's paranoia du jour.

"Patient 1," the Golds write, was admitted to a psychiatric hospital after he went to a federal building in New York City seeking "asylum" from his reality show. He said "his life was like The Truman Show" and he demanded to speak to "the director." He believed the 9/11 attacks had been faked for the benefit of his show, and he'd come to New York to see if the World Trade Center towers were still standing. If they were, this would be definitive proof that he was on a show.

According to clinical reports at the time of his admittance, "Patient 2" believed he was under "the control of an extended network of individuals who are [...] taping him continually [...] and broadcasting the tapes nationally for viewers’ enjoyment as part of a scenario similar to [...] The Truman Show.’’

"Patient 3" was a newspaper reporter. He believed his media colleagues were faking TV, print, and Internet news "for his amusement." When hospitalized for his delusions (and for hinting that he might commit suicide), he thought his hospitalization was part of a "build-up" to a lucrative journalism prize he was about to win — he believed all his friends were in on the joke, and that everyone in the hospital was an actor. He tried to escape from the hospital so he could check the difference between real news on the outside and "fake" news he was receiving there. Drug treatment helped somewhat — by the time he was released, he said ‘‘there is an 80% chance that I will treat the hospitalization as if it is for real.’’

"Patient 4" actually worked on a reality show. He worked in production, but came to believe he was part of the cast of a "secret" show: ‘‘I thought I was a secret contestant on a reality show. I thought I was being filmed. I was convinced I was a contestant and later the TV show would reveal me.’’ He believed the "secret" show was funded by his family, and that the secret film crew could control his thoughts.

For "Patient 5," the delusion took the form of a "scheme," which he said was like The Truman Show. Like Marzano, he said everyone in his life was an actor. He believed he might be recorded in the hospital, and that the news he saw was faked as part of the scheme. He expressed a desire to "get back to my real life’’ to find out ‘‘what’s really going on in the outside world;" he also believed he would be released from the scheme on Christmas Day. Interestingly, "Patient 5" thought he himself was the "master" of the scheme.