Dr Obama Orange A*
Abstract: This case report discusses a peculiar phenomenon affecting a 38-year-old academician who presented with a severe case of Citation Fever. This affliction, characterized by obsessive self-referencing and compulsive citation chasing, represents a looming epidemic in academia. Despite interventions including peer review and humility therapy, the patient demonstrated resistance to treatment. We highlight the signs, diagnostic criteria, and management of this condition to aid others facing similar academic dilemmas.
Introduction
In the competitive ecosystem of academia, a peculiar and newly recognized mental illness has emerged—Citation Fever (CF). This condition, first identified in middle-aged academics, is characterized by an obsessive drive to inflate citation metrics, often at the expense of ethical and intellectual rigor. Citation Fever is unique in that it is the first documented contagious mental illness, with the possible exceptions of conspiracy theorism and yoga. It is transmissible through professional networks, departmental meetings, and collaborative research groups, and carriers may not always present symptoms.
Citation Fever is best defined as a pathological obsession with citation metrics, including H-index, i10-index, and total citation count, to the extent that it interferes with normal academic productivity and professional relationships. While a mild preoccupation with citations is expected in modern academia, Citation Fever progresses into compulsive behaviours that disrupt the delicate balance between genuine scholarship and vanity.
Patients with Citation Fever exhibit a range of distinctive symptoms, including:
- Strategic collaborations: selectively collaborating with highly cited individuals in an attempt to “borrow” their academic aura.
- Hyper-self-citation: the compulsive referencing of one’s own work in every manuscript, regardless of its relevance.
- Impact factor mania: fixation on publishing exclusively in journals with high impact factors, even at the cost of subject matter alignment.
- Citation envy: intense feelings of inadequacy triggered by peers with higher citation counts.
- Metric-induced insomnia: sleepless nights spent refreshing Google Scholar profiles or anxiously awaiting updates on journal citations.
What makes Citation Fever particularly dangerous is its contagious nature. Unlike conventional mental illnesses, this condition spreads through a number of transition pathways:
- Email chains of acceptance rates and journal metrics.
- Conference discussions glorifying citation milestones.
- Institutional policies tying promotions and grants to citation performance.
The illness often begins as benign curiosity about one’s academic footprint but escalates rapidly under the influence of external validation and competitive pressures.
Case Presentation
A 38-year-old male academic, henceforth referred to as Assoc. Prof. X, was admitted via the emergency department after presenting with complaints of persistent restlessness, severe anxiety, and an inability to concentrate on academic tasks (Figure 1). The patient’s symptoms were accompanied by bouts of frustration, frequent email outbursts directed at colleagues, and an uncontrollable compulsion to refresh his Google Scholar profile every 15 minutes. The patient reported a progressive decline in his quality of life over the past two years, coinciding with his promotion to a tenure-track position. He admitted to excessive self-citation, compulsively monitoring citation metrics, and deliberately incorporating irrelevant references to boost his citation count.
On admission, he exhibited mild tachycardia (a heart rate of 102 beats per minute), and elevated blood pressure at 145/90 mmHg. His respiratory rate was 16 breaths per minute, oxygen saturation was 98%, and his temperature was 36.8°C. His physical examination was unremarkable, but his psychological assessment revealed heightened irritability and an inflated sense of academic self-importance. The patient expressed significant distress over colleagues surpassing his H-index, referring to it as “an academic betrayal.” A detailed history revealed no prior psychiatric illnesses, though he described a childhood obsession with gold stars on schoolwork and a college fixation on class rankings.
Laboratory investigations, including a full blood count, liver function tests, and thyroid profile, were within normal limits. However, a comprehensive cognitive assessment demonstrated impaired executive functioning and a fixation on citation- related thoughts, consuming up to 80% of his cognitive bandwidth during structured tasks.
To investigate the physiological underpinnings of Assoc. Prof. X’s condition, fMRI and PET scans were recorded, showing a number of anomalies in the general brainal area (Figure 2). Significant hypertrophy of the egomaniacal cortex and Pariahtalfreudian cleft was observed. These regions of the brain are primarily associated with the processing of emotional and visual data to generate a person’s self-image. Atrophy of the prefontocortical humiliatory lobe, an area critical for perspective-taking and collaborative thinking, was also detected. Finally, functional imaging showed hyperactivation of the psychometric nucleus, a subcortical structure implicated in obsessive behaviours related to quantitative validation.
The findings confirmed a diagnosis of Citation Fever, with secondary Academic Narcissism Syndrome (ANS) contributing to his deteriorating psychological state. Despite these objective findings, the patient displayed minimal insight into his condition and resisted initial attempts at therapeutic intervention.
Discussion
Citation Fever, as exemplified by this unfortunate yet archetypal case, is a symptom of a much larger disease, a cancer that stunting the growth of our collective knowledge. This condition, once thought to be a benign quirk of overachievers, has now evolved into a full-blown epidemic, fuelled by the toxic marriage of institutional pressures and personal vanity.
From an epidemiological perspective, Citation Fever appears to spread most aggressively in environments with rigid performance metrics. Institutions obsessed with impact factors, grant quotas, and promotion benchmarks act as breeding grounds for this intellectual pathogen. Once exposed, individuals often develop Citation Fever through prolonged exposure to academic “influencers,” who propagate the belief that one’s scholarly worth is directly proportional to one’s H-index. The disease exhibits a vicious cycle: higher citations lead to greater recognition, which leads to increased pressure to maintain the facade of relevance. Psychologically, the patient’s fixation on citation metrics raises important philosophical questions: are we truly advancing knowledge, or merely rearranging it in ways that maximize citation counts? The patient’s blatant disregard for relevance in his self-citation practices demonstrates how the academic system incentivizes vanity over validity. His insistence on citing his undergraduate thesis in a manuscript about CRISPR technology is a particularly egregious example of citation inflation—yet one that is disturbingly common among affected individuals.
Therapeutically, Citation Fever remains a challenging condition to manage. Cognitive-behavioural therapy focused on fostering intrinsic motivation and recalibrating academic goals has shown some promise but often fails in severe cases. The patient’s refusal to engage with interventions such as publishing in journals without an impact factor highlights the psychological rigidity of this condition. Experimental treatments, including exposure to fields where citation metrics are irrelevant (e.g., poetry or philosophy), have shown limited success, though many patients report experiencing existential crises when removed from their metric-driven environments.
Ultimately, the root cause of Citation Fever lies not in the individual but in the system. A paradigm shift is needed to prioritize genuine contributions over citation counts, but this is unlikely to happen as long as “Publish or Perish” remains the academic status quo. Until then, cases like this will continue to serve as cautionary tales of ambition run amok, where the pursuit of academic immortality leads only to the hollow satisfaction of being cited… mostly by oneself.
Conclusion
Citation Fever is both a personal tragedy and a systemic indictment, a reminder that even the most brilliant minds can be consumed by the allure of meaningless metrics. This case should prompt academic institutions to reconsider the values they instil in their faculty, lest they perpetuate an environment where impact factors matter more than impact itself.6
Notes and References
1. “Self-Citation Practices in Academic Publishing: Ethical Considerations and Implications for Metrics Inflation” J. A. Trump, R. B. Doe, 2023, Journal of Scholarly Vanity, 15(4), 237–245.
2. “The Metrics Pandemic: How Citation Fever is Reshaping Academic Culture” M. Ego, P. Id, 2022, Impact Factor Quarterly, 8(2), 112–119.
3. “Hyperactivation of the Metrics Nucleus: A Neuroimaging Study of Academic Obsession” A. Narcissus, M. Reflect, 2021, Journal of Cognitive Hubris, 12(3), 89–97.
4. “The Publish-or-Perish Paradox: Examining the Unintended Consequences of Citation-Based Metrics” P. Üblish, P. Erisch, 2020, Academic Anxiety Review, 5(1), 1–10.
5. “From Curiosity to Obsession: The Evolution of Citation Metrics Addiction” G. Scholar, H. Envy, 2024, Journal of Academic Narcissism, 9(5), 315–322.
6. “Citation Fever in a Middle-Aged Professor: A Case Study” O. Orange, 2024, J. Immat. Sci., 4, 58.