At the very least, it seems to signify a certain disconnect with reality... the sort of thing that happens when people are playing out a fantasy version of life in their heads, that doesn't have a whole lot to do with their actual life. I went to HS with a kid like that-- he was on some heavy-duty psych meds, pupils were always little pinpoints, and he was always drawing pictures of military ships, and was totally convinced that he was in contact with the US navy, and that they were taking his suggestions for marine artillery very seriously.