Recent Insights Into Cyberchondria

Cyberchondria in Older Adults and Its Relationship With Cognitive Fusion, Health-Related Quality of Life, and Mental Well-Being: Mediation Analysis

BACKGROUND

Cyberchondria is the compulsive searching for health information online that continues despite harmful effects. It leads to increased health anxiety and lower health-related quality of life (HRQOL). Older adults face higher risks of cyberchondria due to their limited digital literacy skills and more frequent health concerns. However, researchers have not thoroughly studied how cyberchondria affects this age group.

OBJECTIVE

This study aimed to explore cyberchondria in the older population and investigate its relationship with cognitive fusion (ie, the tendency to become entangled with thoughts and perceive them as literal truths that dictate behavior), HRQOL, and mental well-being.

METHODS

A web-based, cross-sectional survey was conducted in May 2024 with a sample of 638 participants from China aged ≥60 years recruited through the online panel of a survey company. The participants completed questionnaires assessing cyberchondria (using the Cyberchondria Severity Scale-12 [CSS-12]), cognitive fusion, HRQOL, and mental well-being. Structural equation modeling (SEM) was used to assess the hypothesized mediation model, and standardized estimates and their 95% CIs were calculated for all structural paths.

RESULTS

Participants had a mean CSS-12 score of 40 (SD 8.5), suggesting a fairly high level of cyberchondria in this sample. Participants with a higher socioeconomic status tended to report lower levels of cyberchondria. The SEM showed that cyberchondria was positively associated with cognitive fusion (β=0.505, P<.001 for both models) and negatively associated with HRQOL (β=-0.221, P<.001) and mental well-being (β=-0.212, P<.001). The mediation model showed a good fit and demonstrated that cognitive fusion fully mediated the total effect of cyberchondria on HRQOL and mental well-being.

CONCLUSIONS

Cyberchondria may be more prominent in older Chinese adults, especially those residing in rural areas and with a lower socioeconomic status. Additionally, cyberchondria can enhance cognitive fusion, contributing to poor HRQOL and mental well-being. Interventions focused on "defusing" cyberchondria-relevant thoughts may help reduce maladaptive behaviors associated with cyberchondria and improve the overall well-being of older populations.

Impact of large language model (ChatGPT) in healthcare: an umbrella review and evidence synthesis

BACKGROUND

The emergence of Artificial Intelligence (AI), particularly Chat Generative Pre-Trained Transformer (ChatGPT), a Large Language Model (LLM), in healthcare promises to reshape patient care, clinical decision-making, and medical education. This review aims to synthesise research findings to consolidate the implications of ChatGPT integration in healthcare and identify research gaps.

MAIN BODY

The umbrella review was conducted following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The Cochrane Library, PubMed, Scopus, Web of Science, and Google Scholar were searched from inception until February 2024. Due to the heterogeneity of the included studies, no quantitative analysis was performed. Instead, information was extracted, summarised, synthesised, and presented in a narrative form. Two reviewers undertook title, abstract, and full text screening independently. The methodological quality and overall rating of the included reviews were assessed using the A Measurement Tool to Assess systematic Reviews (AMSTAR-2) checklist. The review examined 17 studies, comprising 15 systematic reviews and 2 meta-analyses, on ChatGPT in healthcare, revealing diverse focuses. The AMSTAR-2 assessment identified 5 moderate and 12 low-quality reviews, with deficiencies like study design justification and funding source reporting. The most reported theme that emerged was ChatGPT's use in disease diagnosis or clinical decision-making. While 82.4% of studies focused on its general usage, 17.6% explored unique topics like its role in medical examinations and conducting systematic reviews. Among these, 52.9% targeted general healthcare, with 41.2% focusing on specific domains like radiology, neurosurgery, gastroenterology, public health dentistry, and ophthalmology. ChatGPT's use for manuscript review or writing was mentioned in 17.6% of reviews. Promising applications include enhancing patient care and clinical decision-making, though ethical, legal, and accuracy concerns require cautious integration.

CONCLUSION

We summarise the identified areas in reviews regarding ChatGPT's transformative impact in healthcare, highlighting patient care, decision-making, and medical education. Emphasising the importance of ethical regulations and the involvement of policymakers, we urge further investigation to ensure the reliability of ChatGPT and to promote trust in healthcare and research.

Exploring the Relationship Between Cyberchondria and Suicidal Ideation: Cross-Sectional Mediation Analysis

BACKGROUND

The proliferation of internet-based health information has intensified cyberchondria, or anxiety resulting from excessive health-related searches. The relationship between cyberchondria and suicidal ideation remains underexplored, although there are indications that people with high levels of cyberchondria may also be suicidal. Understanding this relationship is critical, given rising digital health-seeking behaviors and the need to mitigate suicide risk. Emerging evidence suggests that psychological distress can mediate the relationship between cyberchondria and suicidal ideation. However, to the best of our knowledge, no research has directly examined these associations.

OBJECTIVE

This study had two aims. The first was to examine the relationship between cyberchondria and suicidal ideation in a sample of the general Chinese population. The second aim was to investigate the possible role of psychological distress, reflecting the symptoms of depression and anxiety, as a mediator in the relationship between cyberchondria and suicidal ideation.

METHODS

Data were obtained from a cross-sectional and web-based survey conducted in 2024. Structural equation modeling analysis was used to assess the hypothesized association between cyberchondria and suicidal ideation, as well as the mediating effect of psychological distress on this association. The Cyberchondria Severity Scale-12 items, Suicidal Ideation Attributes Scale, and Kessler Psychological Distress Scale-10 items were used to measure cyberchondria, suicidal ideation, and psychological distress, respectively. Standardized (β) estimates, along with their 95% CIs, were calculated for all structural paths, adjusting for participants' background characteristics.

RESULTS

A total of 2415 individuals completed the questionnaire (response rate=98.5%). Scores on the Cyberchondria Severity Scale-12 items ranged from 12 to 60, with the mean score being 40 (SD 7.9). The mean score on the Suicidal Ideation Attributes Scale was 12.7 (SD 9.9). Scores on the Kessler Psychological Distress Scale-10 items ranged from 10 to 50, and the mean score was 22 (SD 6.9). Cyberchondria, suicidal ideation, and psychological distress were significantly correlated. Structural equation modeling revealed a significant association between cyberchondria and psychological distress (β=.281; P<.001), between psychological distress and suicidal ideation (β=.504; P<.001), and between cyberchondria and suicidal ideation (β=.107; P<.001). The indirect effect of cyberchondria on suicidal ideation through psychological distress was also significant (β=.142; P<.001).

CONCLUSIONS

The main contribution of this study is that it highlights an important relationship between cyberchondria and suicidal ideation, with a direct and statistically significant association between these variables. Their relationship is also mediated by psychological distress, which reflects the role of depressive and anxiety symptoms.

The Relationship Between E-Health Literacy, Health Anxiety, Cyberchondria, and Death Anxiety in University Students That Study in Health Related Department

Introduction

While the Internet can be a valuable resource for learning about health issues, for those without adequate e-health literacy skills, it can have adverse effects on unwanted anxiety and cyberchondria risk. Improving e-health literacy is essential to manage health and death anxiety and help reduce the risk of cyberchondria. The aim of this study is to determine the e-health literacy, health anxiety, cyberchondria and death anxiety levels of university students, evaluate them in terms of independent variables and examine the relationship between the scales.

Methods

The study was completed with 568 students receiving education in the health department of a university. Data were obtained using the e-Health Literacy Scale, Health Anxiety Inventory, Cyberchondria Severity Scale, and Death Anxiety Scale. The chi-square, Mann-Whitney U, Kruskal-Wallis, Tamhane's T2 post hoc tests, and Spearman correlation were used to analyze the data.

Results

The mean score of e-health literacy was 28.63±4.65; health anxiety was 19.11±8.37, cyberchondria was 86.30±18.28 and death anxiety was 7.34±2.14. Cyberchondria is low in women and those who do not conduct online research on health. E-health literacy was higher in those earning above the minimum wage. Health and death anxiety was low in men and in those who did not conduct online health-related research. Health anxiety was positively correlated with cyberchondria and death anxiety and negatively correlated with e-health literacy. There was a positive relationship between cyberchondria and E-health literacy and death anxiety. This study highlights the complex relationship between eHealth literacy, health anxiety, cyberchondria and death anxiety. It shows that low e-health literacy can increase health anxiety, which in turn can worsen cyberchondria and death anxiety. By emphasising the importance of e-health literacy in health education, the findings may help students manage their anxiety, make informed health decisions, and increase their professional competence.

Evaluation Of the Readiness of Family Physicians In the Prevention of Cyberchondria

OBJECTIVE

The purpose of this research is to determine the readiness of family physicians to prevent cyberchondria.

METHODS

The Family Physicians' Cyberchondria Levels Assessment Questionnaire was applied to 124 family physicians to determine readiness.

RESULTS

Family physicians mention that there can be accurate data on diagnosis and treatments on the internet (62%), but patients' anxiety increases (88%); reach physicians and find answers on the websites of family physicians. Individuals with low health literacy research on the internet are concerned about family physicians (84.6%). Family physicians declare patients have medication with Internet information (84%), diagnose themselves with research on the internet (85.2%), and have high anxiety levels (83.2%). The family physicians use WhatsApp (90.3%) to answer patients' questions and increase cyberchondria awareness. The family physicians have knowledge about cyberchondria, accept cyberchondria as a health problem, and have computer literacy.

CONCLUSIONS

The Internet provides individuals with a low-cost and easily accessible source of health information. The patients researching the internet have high anxiety and low health literacy. To prevent cyberchondria, direct communication with family physicians, development of health literacy, and facilitating access to communication and counseling services on the internet by central health authorities are essential.

Investigation of the effect of internet addiction on cyberchondria

This research was conducted to examine the effect of internet addiction on cyberchondria. The research is important to understand how today's digital technologies contribute to health-related concerns and affect individuals' perceptions of health. Quantitative research design was used in this research conducted in Konya, a metropolitan city in Turkey. The study was conducted using the convenience sampling method on 403 participants. In the research, 'Personal Information Form', 'Internet Addiction Scale' and 'Cyberchondria Scale' were used. The data were analyzed with the SPSS program. As an analysis method, upon determining that the data were normally distributed, t-test, ANOVA, Pearson correlation and simple linear regression analyzes were applied in independent groups. The majority of participants (69%) were female, 52.9% were between the ages of 18-27 and 53.8% were married. In terms of education level, 44.9% had a bachelor's degree or higher, and 59.6% earned minimum wage or less. Among the occupational groups, the largest proportion was students (31.5%), and their daily internet use was mostly 2-3 hours (44.4%). Internet is most frequently used for social media (47.4%) and news/agenda follow-up (25.1%). Within the scope of the research, internet addiction varies significantly according to the participants' age groups, education levels, professions, average daily internet usage time, and internet usage purposes; it was found that the cyberchondria levels of the participants showed significant differences according to the variables of income level, profession, daily internet usage time and internet use purpose. The research revealed a positive and significant relationship between the level of internet addiction and the level of cyberchondria. It has also been observed that internet addiction has a positive and significant effect on cyberchondria. These results show that cyberchondria tendencies become stronger with the increase in internet use among individuals.

Online Health Information Seeking and Cyberchondria Among Men at Risk of HIV Infection: A Moderated Mediation Model

Objectives

This study investigates the relationship between HIV/AIDS-related online health information seeking (OHIS) and cyberchondria among Chinese men who have engaged in high-risk sexual behaviors. It proposes a moderated mediation model to explore the role of query escalation as a mediator and intolerance of uncertainty (IU) as a moderator in this relationship.

Method

A survey was conducted with 227 men from an online community focused on HIV/AIDS-related fear in China. Participants reported their frequency of OHIS, levels of query escalation and IU, and experiences of cyberchondria. The study employed the PROCESS macro to examine the proposed moderated mediation model.

Results

The findings indicated that frequent OHIS significantly predicts cyberchondria, with query escalation mediating this relationship. Additionally, IU moderates the mediation pathway, weakening the effect of query escalation on cyberchondria when IU is high. This suggests that individuals with high IU are less likely to experience escalating health inquiries and, consequently, cyberchondria.

Conclusions

The study highlights the complex interaction between OHIS, query escalation, and IU in predicting cyberchondria among high-risk groups. These insights are crucial for designing effective interventions to mitigate cyberchondria by addressing the escalation of health information seeking and managing uncertainty intolerance in this population.

The Relationship between Parents' Use of the Pediatric Emergency Department and Cyberchondria

The study aimed to investigate the correlation between children's attendance at the emergency department and the cyberchondria of parents. The population for this cross-sectional study comprised parents of children aged 0 to 18 attending the emergency department. Research data were collected using an Information Form, the Cyberchondria Severity Scale (CSS). The participants had mean CSS scores of 41.45 ± 19.22. There were significant differences observed between the reason for choosing the emergency department with mean scores for the total CSS (F = 2.289, P = .021), distress (F = 2.466, P = .013), and compulsion (F = 2.822, P = .005) subscales. A weak positive correlation was identified between the number of attendances at the emergency department in the last year and the excessiveness (r = .204) subscale. Participants had moderate levels of CSS. According to the research findings, most parents attended the emergency department for non-urgent reasons. In addition, as the cyberchondria severity level of parents increased, their attendance at health institutions and emergency departments was determined to increase.

The relationship between cyberchondria and health literacy among first-year nursing students: the mediating effect of health anxiety

BACKGROUND

First-year nursing students are at a critical juncture in their education. They are transitioning from laypersons to healthcare professionals, and students are frequently exposed to medical information in academic settings and through personal research. This exposure can sometimes lead to cyberchondria; improving health literacy and managing health anxiety are critical strategies for reducing the incidence of cyberchondria.

AIM

Investigate the mediating effect of health anxiety on cyberchondria and health literacy among first-year nursing students.

METHODS

A cross-sectional correlational research design was used in this study. The study was conducted with 475 students in October 2023 during the first semester of the academic year 2023-2024.

RESULTS

Cyberchondria and health literacy levels were both moderate. In addition, the degree of health anxiety among first-year Nursing Students was mild, too. The results showed that the association between Cyberchondria and Health Literacy was partially mediated by health anxiety.

CONCLUSION AND IMPLICATIONS

This study highlights the sophisticated relationship between cyberchondria, health literacy, and anxiety among first-year nursing students. It demonstrates that lower health literacy can lead to increased health anxiety, which in turn exacerbates cyberchondria. To mitigate these issues, it is essential to enhance health literacy and provide support for managing health anxiety within nursing education programs. By doing so, we can help nursing students navigate online health information effectively and reduce unnecessary health-related anxieties, promoting better educational outcomes and overall well-being.

[Health anxiety: Another epidemic to prepare for]

Health anxiety (HA) is a frequent problem (up to 20% of consultants in the context of secondary care) responsible for decreased well-being, disability, somatic and psychiatric complications, which contributes to high healthcare expenditures at the population level. It is likely, if not definitely established, that the prevalence of ACS is increasing, and this can partly be explained by the growing medicalization of society in general, the appetite of Media for health issues, and the uncontrolled use of the Internet (which can lead certain vulnerable subjects to cyberchondria). The pandemic of COVID-19 could have contributed to it, at least by the significant increase in the overall level of psychological distress in the population it has caused, although this has not formally been demonstrated to date. The diagnosis of ACS is easy, as soon as its assessment is considered as a mandatory part of any medical consultation. Certain intuitive attitudes of doctors, such as reassurance, prove to be iatrogenic for the patient with HA. The management of HA can be facilitated by an acculturation of physicians to cognitive conceptions of anxiety in general and HA in particular. HA is effectively treatable by certain psychotherapy and in the first place cognitive and behavioral therapies (CBT), but the availability of trained therapists and accessible at a lower cost is sorely lacking, particularly in France.

Are there 34,000 human emotions? Deconstructing patterns of scientific misinformation

BACKGROUND

Scientific misinformation is a much-discussed topic, and the COVID-19 crisis has highlighted the importance of reliability in science and research. However, limiting misinformation is complicated because of the growing number of communication channels, in which scientific and nonscientific content are often mixed.

METHODS

This case study combines the examination of references, online observation, and a content and frequency analysis to investigate the dissemination of scientific misinformation in the interplay of different genres and media.

RESULTS

Using the example of the claimed existence of 34,000 human emotions, this study demonstrates how questionable statements are spread in science, popular science, and pseudoscience, making it particularly challenging to track and correct them.

CONCLUSIONS

The findings highlight epistemic authority, trust, and injustice within and between scientific and nonscientific communities. The author argues that, in the digital age, researchers should defend and monitor scientific principles beyond academia.

Acceptance of a French e-Mental Health Information Website (CléPsy) for Families: A Web-Based Survey

Background

Childhood mental health issues concern a large amount of children worldwide and represent a major public health challenge. The lack of knowledge among parents and caregivers in this area hinders effective management. Empowering families enhances their ability to address their children's difficulties, boosts health literacy, and promotes positive changes. However, seeking reliable mental health information remains challenging due to fear, stigma, and mistrust of the sources of information.

Objective

This study evaluates the acceptance of a website, CléPsy, designed to provide reliable information and practical tools for families concerned about child mental health and parenting.

Methods

This study examines user characteristics and assesses ease of use, usefulness, trustworthiness, and attitude toward using the website. Platform users were given access to a self-administered questionnaire by means of mailing lists, social networks, and posters between May and July 2022.

Results

Findings indicate that the wide majority of the 317 responders agreed or somewhat agreed that the website made discussions about mental health easier with professionals (n=264, 83.3%) or with their relatives (n=260, 82.1%). According to the ANOVA, there was a significant effect between educational level and perceived trust (F6=3.03; P=.007) and between frequency of use and perceived usefulness (F2=4.85; P=.008).

Conclusions

The study underlines the importance of user experience and design in web-based health information dissemination and emphasizes the need for accessible and evidence-based information. Although the study has limitations, it provides preliminary support for the acceptability and usefulness of the website. Future efforts should focus on inclusive co-construction with users and addressing the information needs of families from diverse cultural and educational backgrounds.

Digital surveillance: The interest in mouthwash-related information

BACKGROUND

The comprehension of the interests of Internet users regarding their health-related searches may reveal the community's demands about oral health. The study aimed to characterize the interests of Google users related to mouthwash in Australia, Brazil, Chile, Japan, Mexico, Russia, the United Kingdom, the United States, Saudi Arabia and South Africa applying the Google Trends.

METHODS

This longitudinal retrospective study analysed the mouthwash-related interest of Google users from January 2004 to December 2020. The monthly variation of relative search volume (RSV) and the main queries related were determined using Google Trends. Autoregressive integrated moving average (ARIMA) forecasting models were built to establish the predictive RSV values for mouthwash for additional 12 months. Auto-correlation plots and a general additive model (GAM) were used to diagnose trends and seasonality in RSV curves. In addition, the influence of social isolation related to the outbreak of COVID-19 were analysed.

RESULTS

The RSVs curves showed a considerable increase in searches related to mouthwash to AUS, BRA, JAP, MEX, GBR and USA (RSV > 25), while the growth was slight to CHI, KSA, RSA and RUS (RSV < 25) over the years, without influence of monthly seasonality. All countries showed a significant increase in mouthwash interest after the outbreak of COVID-19, except for KSA and RUS. The mouthwash-related searches were associated to specific brands or chemical compositions, treatments, whitening agents, homemade mouthwash and indications for the 'best mouthwash'.

CONCLUSIONS

In general, there was an increasing interest of Google users in mouthwash-related topics between 2004 and 2020. In addition, in most countries, there was an expansion in searches during the social isolation of the COVID-19 pandemics.

Mental health in patients affected by atopic dermatitis: which effects of treatment with dupilumab?

Atopic dermatitis (AD) is an inflammatory skin disease. Patients with AD are prone to develop anxiety and mood disorders. Aim of this study is to investigate if treatment with dupilumab may improve mental health status of patients affected by AD. A total of 66 patients with severe AD were included: 24 subjects were candidate or have just started (one month) treatment with dupilumab, and 42 have been in treatment for one year. 25.8%, 30.3%, and 45.5% of the total sample showed, respectively, clinically significant anxiety, depression, and symptoms of Internet addiction. Patients with anxiety symptoms resulted to have more severe AD, more sleep problems ( P  = 0.028), less quality of life ( P  = 0.001), more severe depressive symptoms ( P  < 0.001), to be more frequently women ( P  = 0.016), to be less frequently treated with dupilumab for one year ( P  = 0.025). Similarly, patients with clinically significant depressive symptoms resulted to have more severe AD, more sleep problems ( P  = 0.003), less quality of life ( P  < 0.001), more severe anxiety symptoms ( P  < 0.001), to be less frequently treated with dupilumab for one year ( P  = 0.008). Patients with AD treated for one year with dupilumab showed a better mental health profile in terms of less severe anxiety and depression with respect to their counterparts.

Internet use by pregnant women during prenatal care

OBJECTIVE

The search for medical information on the internet is a part of people's daily lives. Exponential volumes of data are available through various media and platforms. There are several problems related to the ease of creating and accessing medical information on the internet, as evidenced by the quantity of false content and increasing anxiety due to the consumption of these data. In light of this accessibility, it is necessary to understand how people use internet-based medical information and its impact on specific populations. This prospective study aimed to analyze pregnant women's behavior when searching for health-related information on the internet, and how they were influenced by the information.

METHODS

Questionnaires were administered to the participants during their immediate puerperium, and their answers were tabulated.

RESULTS

Three hundred and two patients answered the questionnaires. We observed that internet use was frequent, and most patients discussed the findings with their physicians. However, this did not affect the delivery routes.

CONCLUSION

The search for health information by pregnant women is very prevalent but does not interfere with the delivery route.

Does Health Literacy Protect Against Cyberchondria: A Cross-Sectional Study?

Introduction: The use of online health resources and self-diagnosis intensified during the COVID-19 pandemic, often resulting in symptoms of cyberchondria. However, little is still known about this phenomenon's real scale and determinants. The aim of the study was to examine the prevalence of cyberchondria among adult internet users in Poland. Furthermore, the study was focused on analyzing the determinants of cyberchondria, with special regard to health literacy (HL) and e-health literacy (eHL). Methods: The analysis was based on data from a computer-assisted web-based interviewing survey performed with a sample of 1,613 internet users. Uni- and multivariable linear regression models were developed for potential determinants of cyberchondria. Results: Younger respondents were more likely to have higher cyberchondria scores than older respondents. Men were more likely to have lower cyberchondria scores than women. Higher health anxiety was significantly associated with cyberchondria severity. In the multivariable regression model, the severity of cyberchondria was significantly higher among respondents with inadequate rather than sufficient HL (B = 6.24, p < 0.001). In turn, greater eHL was significantly correlated with more severe cyberchondria (B = 0.92, p < 0.001). Conclusions: Our study confirmed that HL may be perceived as a protecting factor against cyberchondria. Unexpectedly, higher eHL predicts more severe cyberchondria.

Cyberchondria severity and utilization of health services in Polish society: a cross-sectional study

BACKGROUND

It has been suggested that cyberchondria leads to increased utilization of healthcare services. Unfortunately, not many studies have analyzed this effect comprehensively. The aim of this study was to analyze the relationship between cyberchondria severity and the utilization of healthcare services among adult Internet users after adjusting for sociodemographic characteristics and the health status of respondents.

METHODS

The analysis detailed in this paper examined data from a computer-based, web-based interviewing survey performed among a representative sample of 1613 Polish Internet users. Cyberchondria severity was assessed with the Cyberchondria Severity Scale (CSS). The variables reflecting the use of healthcare services were based on the frequency of visits to family physicians and specialists, diagnostic procedures, hospital admissions, and emergency services, and finally being vaccinated against COVID-19. The effect of cyberchondria severity on the utilization of healthcare services and alternative medicine was adjusted for key sociodemographic variables, the presence of chronic diseases, disability, and unspecific symptoms. For variables reflecting the use of services, ordinal logistic regression and multivariable logistic regression models were developed.

RESULTS

Cyberchondria severity was a significant predictor of the utilization of all but one of the analyzed healthcare services and alternative medicine. The odds of being in a higher category of the utilization of visits to family physicians and specialists, hospital admissions, emergency services and alternative medicine services increased by a factor of 1.01-1.02 for every unit increase of the cyberchondria score. The cyberchondria score was a negative predictor of COVID-19 vaccine uptake. The effect of cyberchondria on outcome variables was independent of the level of health anxiety, sociodemographic variables, and variables reflecting the health status of respondents.

CONCLUSIONS

Cyberchondria leads to more intensive use of nearly all healthcare services, but in the case of vaccination against COVID-19, cyberchondria severity was a negative predictor. Cyberchondria's effect extends beyond health anxiety.

Turning Lemons into Lemonade: Social Support as a Moderator of the Relationship Between Technostress and Quality of Life Among University Students

Purpose

The overuse of internet-based technologies as a means of coping with the stress they generate has resulted in an alarming level of addiction, adversely impacting the quality of life and overall health of younger individuals. This social detachment, in turn, contributes to both physical and mental health deterioration. The potential remedy for this predicament lies in the application of social support as an antidote to internet addiction. In this context, our present study employs the Stress-Strain-Outcome model to explore the indirect effects of internet addiction and the moderating role of social support in relation to the influence of technostress on the quality of life of adults.

Methods

We adopted a time-lagged design to collect data from university graduates and evaluated our study hypotheses using Mplus.

Results

Our empirical findings highlight the significant influence of technostress on internet addiction, with the latter significantly mediating the relationship between technostress and quality of life. Furthermore, our results reveal that social support effectively moderates the indirect effects of technostress on quality of life through its impact on internet addiction.

Conclusion

These findings can help researchers and educators better understand the underlying mechanisms between technostress and quality of life with social support as the silver lining. This form of social support holds the potential not only to alleviate internet addiction but also to positively enhance the quality of life and overall wellbeing of individuals facing these challenges. The implications of these findings and avenues for future research are also discussed.

Can't stop, won't stop - understanding anxiety's role in cyberchondria among pregnant women

Online health research is common during pregnancy, especially if women are facing complications. Given the unpleasant emotions women experience after research, it is surprising that cyberchondria, excessive and repeated online health research caused by anxiety that intensifies such anxiety, has not been studied in pregnant women. Therefore, the aim of this study was to examine the predictors of cyberchondria among women with and without pregnancy complications, accounting for health anxiety (a worry regarding personal health) and pregnancy-specific anxiety (concerns related to pregnancy and childbirth). A total of 360 pregnant women completed a questionnaire consisted of Short Health Anxiety Inventory, Pregnancy Concerns Scale and Short Cyberchondria Scale. The results of one-way MANOVA showed that women who had medically complicated pregnancy had higher levels of health anxiety, pregnancy-specific anxiety and cyberchondria compared to those without complications. A hierarchical multiple regression analysis showed that health anxiety and pregnancy-specific anxiety were predictors of cyberchondria but had different roles depending on complications. Pregnancy-specific anxiety predicted cyberchondria in both groups above health anxiety. Health anxiety predicted cyberchondria only in women without complications. In conclusion, women with complications have a higher chance of experiencing cyberchondria. Pregnancy-specific and health anxiety are risk factors for cyberchondria in pregnant women.

Only the anxious ones? Identifying characteristics of symptom checker app users: a cross-sectional survey

BACKGROUND

Symptom checker applications (SCAs) may help laypeople classify their symptoms and receive recommendations on medically appropriate actions. Further research is necessary to estimate the influence of user characteristics, attitudes and (e)health-related competencies.

OBJECTIVE

The objective of this study is to identify meaningful predictors for SCA use considering user characteristics.

METHODS

An explorative cross-sectional survey was conducted to investigate German citizens' demographics, eHealth literacy, hypochondria, self-efficacy, and affinity for technology using German language-validated questionnaires. A total of 869 participants were eligible for inclusion in the study. As n = 67 SCA users were assessed and matched 1:1 with non-users, a sample of n = 134 participants were assessed in the main analysis. A four-step analysis was conducted involving explorative predictor selection, model comparisons, and parameter estimates for selected predictors, including sensitivity and post hoc analyses.

RESULTS

Hypochondria and self-efficacy were identified as meaningful predictors of SCA use. Hypochondria showed a consistent and significant effect across all analyses OR: 1.24-1.26 (95% CI: 1.1-1.4). Self-efficacy OR: 0.64-0.93 (95% CI: 0.3-1.4) showed inconsistent and nonsignificant results, leaving its role in SCA use unclear. Over half of the SCA users in our sample met the classification for hypochondria (cut-off on the WI of 5).

CONCLUSIONS

Hypochondria has emerged as a significant predictor of SCA use with a consistently stable effect, yet according to the literature, individuals with this trait may be less likely to benefit from SCA despite their greater likelihood of using it. These users could be further unsettled by risk-averse triage and unlikely but serious diagnosis suggestions.

TRIAL REGISTRATION

The study was registered in the German Clinical Trials Register (DRKS) DRKS00022465, DERR1- https://doi.org/10.2196/34026 .

Exploring how health-related advertising interference contributes to the development of cyberchondria: A stressor-strain-outcome approach

Objectives

Cyberchondria is increasingly recognized as the dark side of digital health, given the pervasive use of the internet as a main source of health information in people's daily lives. While previous studies have identified many factors contributing to cyberchondria, there is a dearth of research on the impact of health-related advertisements. Therefore, this study adopts the stressor-strain-outcome (SSO) model to investigate how health-related advertising interference is directly and indirectly related to cyberchondria.

Methods

To empirically validate the proposed research model, we conducted an online survey with 437 internet users with medical information seeking experience in China. Structural equation modeling (SEM) was employed to analyze the survey data.

Results

Our findings revealed a positive, direct association between health-related advertising interference and cyberchondria. Meanwhile, advertising interference was positively related to both information overload and information irrelevance, with the former further predicting cyberchondria. Moreover, doctor-patient communication weakened the positive effect of information overload on cyberchondria.

Conclusions

The study not only theoretically contributes to the literature by theorizing the relationship between health-related advertising interference and cyberchondria but also practically underlines the pivotal role of effective doctor-patient communication in reducing the development of cyberchondria.

Understanding cyberchondria in pregnant women: longitudinal assessment of risk factors, triggers, and outcomes

Pregnancy often triggers anxiety and health concerns in women, leading many to search for health information online. Excessive, compulsive, and repetitive online health research, accompanied by heightened anxiety, can result in cyberchondria. This study aimed to explore the risk factors, triggers, and outcomes of cyberchondria in pregnant women. A total of 149 participants completed an online questionnaire longitudinally across three stages of pregnancy: early (14-19 weeks), mid (24-29 weeks), and late pregnancy (34-39 weeks). The findings revealed that health anxiety and the cognitive component of anxiety sensitivity are risk factors for cyberchondria during pregnancy. Pregnancy concerns related to motherhood emerged as triggers for cyberchondria. While a connection between cyberchondria and fear of birth was observed, fear of birth did not appear to be a direct outcome of cyberchondria. These results highlight the importance of addressing health anxiety, cognitive anxiety sensitivity and motherhood concerns in prenatal care and support interventions. Understanding the factors contributing to cyberchondria in pregnant women can assist healthcare professionals in providing targeted support and resources to mitigate excessive online health searching behaviors and alleviate anxiety during pregnancy.

The short-form of the Cyberchondria Severity Scale (CSS-12): Adaptation and validation of the Spanish version in young Peruvian students

BACKGROUND

Cyberchondria is defined as the increase in health-related anxiety or anguish associated with excessive or repeated online searches for health-related information. Our objective was to cross-culturally adapt and validate the CSS-12 scale for Peruvian Spanish speakers, to determine whether the Bifactor model works as well in our population as in previous studies' and to explore whether the Bifactor-ESEM is a more suitable model.

METHODS

We performed a cultural adaptation using the Delphi method and a validation study on medical students between 2018 and 2019. Reliability was evaluated by using Cronbach's alpha (α) and McDonald's omega (Ω) for internal consistency, and Pearson's r and intraclass correlation coefficient (ICC), for test-retest reliability. We evaluated construct validity by contrasting four measurement models for the CSS-12 and the convergent validity against health anxiety.

RESULTS

The Spanish CSS-12 showed excellent reliability (α = .93; Ω = .93; ICC = .93; r = .96). The Bifactor ESEM model showed the best fit, supporting a unidimensional measure of the general cyberchondria. This measure was positively associated with health anxiety (r = .51).

CONCLUSIONS

The Spanish CSS-12 provides a valid and reliable unidimensional measure of cyberchondria, which is distinguishable from the more general health anxiety. This can be applied to similar populations and future research. The Bifactor-ESEM model appears to offer a more accurate and realistic representation of the multifaceted nature of cyberchondria. We provide a free-to-use form of the Spanish CSS-12 as supplemental material.

Brave New Healthcare: A Narrative Review of Digital Healthcare in American Medicine

The digital revolution has had a profound effect on American and global healthcare, which was accelerated by the pandemic and telehealth applications. Digital health also includes popular and more esoteric forms of wearable monitoring systems and interscatter and other wireless technologies that facilitate their telemetry. The rise in artificial intelligence (AI) and machine learning (ML) may serve to improve interpretation from imaging technologies to electrocardiography or electroencephalographic tracings, and new ML techniques may allow these systems to scan data to discern and contextualize patterns that may have evaded human physicians. The necessity of virtual care during the pandemic has morphed into new treatment paradigms, which have gained patient acceptance but still raise issues with respect to privacy laws and credentialing. Augmented and virtual reality tools can facilitate surgical planning and "hands-on" clinical training activities. Patients are working with new frontiers in digital health in the form of "Dr. Google" and patient support websites to learn or share medical information. Patient-facing digital health information is both a blessing and curse, in that it can be a boon to health-literate patients who seek to be more active in their own care. On the other hand, digital health information can lead to false conclusions, catastrophizing, misunderstandings, and "cyberchondria." The role of blockchain, familiar from cryptocurrency, may play a role in future healthcare information and would serve as a disruptive, decentralizing, and potentially beneficial change. These important changes are both exciting and perplexing as clinicians and their patients learn to navigate this new system and how we address the questions it raises, such as medical privacy in a digital age. The goal of this review is to explore the vast range of digital health and how it may impact the healthcare system.

The mediating role of rumination between stress appraisal and cyberchondria

Cyberchondria, defined as excessive concern about one's health and looking for solutions to health problems on the Internet, is becoming increasingly common. This paper examines the relations between the dimensions of stress appraisal (threat, challenge-activity, challenge-passivity, harm/loss) and cyberchondria. We also tested whether these relations were mediated by rumination. The study included a nonclinical sample of N = 615 participants aged 18 to 83 years (M = 43.86, SD = 14.57, 53 % women), who completed the short version of the Cyberchondria Severity Scale, the Rumination Scale, and the Stress Appraisal Questionnaire. We used the Computer-Assisted Web Interview (CAWI) method. The results revealed that rumination was a partial mediator between stress as a threat and cyberchondria and between stress as a harm/loss and cyberchondria. Cyberchondria was positively related to rumination, stress as a threat, and stress as a harm/loss and negatively related to the challenge-activity dimension of stress appraisal. The study indicates that stress appraisal is linked to cyberchondria and that rumination plays an important role in this relationship.

Cyberchondria and Chinese Adolescent Mental Health in the Age of COVID-19 Pandemic

One of the far-reaching impacts of the COVID-19 pandemic is that it has become the fertile soil of cyberchondria. Adolescents' mental health was severely hit by this by-product of the COVID-19 pandemic both due to the direct effects and its indirect effects on security. This study investigated whether and how cyberchondria was associated with Chinese adolescents' mental health (i.e., well-being and depressive symptoms). Based on a large Internet sample (N = 1,108, 67.5 percent female, M_age = 16.78 years), cyberchondria, psychological insecurity, mental health, and a series of covariates were assessed. Preliminary analyses were conducted in SPSS Statistics software and main analyses were conducted in Mplus. Path analyses indicated that (a) cyberchondria was negatively associated with well-being (b = -0.12, p = 0.001) and positively associated with depressive symptoms (b = 0.17, p < 0.001); (b) psychological insecurity could fully mediate the association between cyberchondria and mental health (indirect effect _well-being = -0.15, 95% confidence interval [CI -0.19 to -0.12] and indirect effect _{depressive symptoms} = 0.15, 95% CI [0.12 to 0.19]); (c) the two dimensions (social insecurity and uncertainty) of psychological insecurity could play the mediating role in the associations between cyberchondria and mental health, uniquely and parallelly; and (d) these results did not vary by gender. This study suggests that cyberchondria may arouse individuals' psychological insecurity about interpersonal interaction and the development of events, which ultimately decreases their well-being and increases the risk of depressive symptoms. These findings facilitate the establishment and implementation of relevant prevention and intervention programs.

The Relationship between Orthorexia Nervosa and Obsessive Compulsive Disorder

Orthorexia nervosa (ON) is characterized by an intense avoidance of foods considered unhealthy, obsession with healthy eating behaviors, and pathological fixation on healthy foods. Although there are still debates in the literature about the psychological factors and symptoms of ON, it should be noted that many of the symptoms share common features with obsessive compulsive disorder (OCD). The aim of the present study was to investigate the relationship between ON and OCD with its subtypes. In this framework, the cross-sectional study was conducted with an opportunistic sample of 587 participants (86% women and 14% men), with an average age of 29.32 (s.d. = 11.29; age range = 15-74). Our work showed that almost all OCD subtypes were largely correlated with ON. The lowest correlation was for "Checking" and the highest for "Obsession". Overall, the OCD subtypes (i.e., Indecisiveness, Just Right, Obsession, and Hoarding) were more strongly associated with ON measures, while subtypes Checking and Contamination, although positively associated, had lower correlation coefficients.

Are Cyberchondria and Intolerance of Uncertainty Related to Smartphone Addiction?

Smartphones are a medium for performing online activities, and one such activity could be the compulsive online health information search - cyberchondria. This study aimed to test whether cyberchondria and intolerance of uncertainty (IU) positively predict smartphone addiction (SA), adjusted for age, gender, daily use duration, the reason for using smartphones, and symptoms of anxiety and depression. The sample consisted of 471 adults (55.2% women) from the general population without chronic diseases (Mage = 38.67). Regression analysis showed that IU was a positive predictor of SA (β = .17, p < .001), as well as cyberchondria (β = .14, p < .001), which had a unique contribution to the explanation of SA, relative to IU. Other significant predictors were average daily smartphone use and entertainment use, the latter being the strongest predictor in the model. These results revealed cyberchondria as a unique predictor of SA.

Predictors of Cyberchondria during the COVID-19 pandemic: A cross-sectional study using supervised machine learning

BACKGROUND

Cyberchondria is characterized by repeated and compulsive online searches for health information, resulting in increased health anxiety and distress. It has been conceptualized as a multi-dimensional construct fueled by both anxiety and compulsivity-related factors and described as a "transdiagnostic compulsive behavioral syndrome" which is associated with health anxiety, problematic internet use and obsessive-compulsive symptoms. Cyberchondria is not included in the ICD-11 or the DSM-5, and its defining features, etiological mechanisms and assessment continue to be debated.

OBJECTIVE

This study aimed to investigate changes in the severity of cyberchondria during the pandemic and identify predictors of cyberchondria at this time.

METHODS

Data collection started on May 4, 2020 and ended on June 10, 2020, which corresponds to the first wave of the COVID-19 pandemic in Europe. At the time the present study took place, French-speaking countries in Europe (France, Switzerland, Belgium and Luxembourg) all implemented lockdown or semi-lockdown measures. The survey consisted of a questionnaire collecting demographic information (sex, age, education level and country of residence) and information on socioeconomic circumstances during the first lockdown (e.g., economic situation, housing and employment status), and was followed by several instruments assessing various psychological and health-related constructs. Inclusion criteria for the study were being at least 18 years of age and having a good understanding of French. Self-report data were collected from 725 participants aged 18 to 77 years (mean 33.29, SD 12.88 years), with females constituting the majority (416/725, 57.4%).

RESULTS

The results show that the COVID-19 pandemic affected various facets of cyberchondria: cyberchondria-related distress and interference with functioning increased (distress z=-3.651, P<.001; compulsion z=-5.697, P<.001), whereas the reassurance facet of cyberchondria decreased (z=-6.680, P<.001). Also, COVID-19-related fears and health anxiety emerged as the strongest predictors of cyberchondria-related distress and interference with functioning during the pandemic.

CONCLUSIONS

These findings provide evidence about the impact of the COVID-19 pandemic on cyberchondria and identify factors that should be considered in efforts to prevent and manage cyberchondria at times of public health crises. Also, they are consistent with the theoretical model of cyberchondria during the COVID-19 pandemic proposed by Starcevic and his colleagues in 2020. In addition, the findings have implications for the conceptualization and future assessment of cyberchondria.

Understanding Health Attitudes and Behavior

Individual attitudes and behavior related to health and disease are major components of clinical encounters. These factors shape lifestyle, presentation of symptoms, access to patient care, interactions between patients and physicians, adherence to medical advice, and response to treatment. Health attitudes and behavior may range from anxiety and worry about illness to various forms of denial, such as delay of seeking care and lack of adherence to treatment. When attitudes result in health-damaging behavior, they may be particularly difficult to understand and become a source of frustration to both physicians and patients. Devising appropriate responses by health care providers may contribute to improving final outcomes and decrease health care costs. In particular, health behavior is likely to play a major role in the process of convalescence, in self-management of chronic conditions, in determining a state of recovery, and whenever a rehabilitation process is involved. Understanding the spectrum of health attitudes and behavior is also crucial for motivating people to make beneficial changes (lifestyle medicine), as well as for implementing safety procedures in the community.

Cyberchondria: a Growing Concern During the COVID-19 Pandemic and a Possible Addictive Disorder?

Purpose of Review

The main purpose of this narrative review is to provide a brief overview of the current empirical evidence regarding the conceptualization, assessment, and treatment of cyberchondria, with a focus on the potential classification of cyberchondria as a behavioral addiction. Although cyberchondria has been widely associated with anxiety, it has also been suggested that it may be linked to obsessive-compulsive features. A less explored proposal is the categorization of cyberchondria as a behavioral addiction. The present review explores the existing literature with respect to the possible classification of cyberchondria as a behavioral addiction by considering cyberchondria with respect to components of the interaction of person, affect, cognition and execution model.

Recent Findings

There is a lack of consensus regarding the definition and conceptualization of cyberchondria. The empirical evidence available to date suggests that cyberchondria is a multifactorial construct that operates transdiagnostically, particularly with respect to obsessive-compulsive-related disorders and health-related anxiety. The extent to which the condition may reflect a behavioral addiction as a form of problematic use of the internet also warrants consideration. Cyberchondria may have become more prevalent during the COVID-19 pandemic, with particular populations prone to health-related anxiety likely having greater vulnerability. Existing data in part support the potential classification of cyberchondria as a behavioral addiction, although many gaps in understanding currently exist.

Summary

Cyberchondria appears to be a growing concern. However, there is not yet enough empirical evidence to determine whether this clinical condition has enough similarities with behavioral addictions to be considered as one. Likewise, psychometric instruments that exist to date have not been designed from the theoretical framework of behavioral addictions, so most of the factors that they evaluate may be preferentially related to anxiety. Finally, there is still no consensus on whether cyberchondria should be addressed in the context of health anxiety interventions, OCRD, or behavioral addictions; thus, more empirical evidence is needed.

Challenging Interactions Between Patients With Severe Health Anxiety and the Healthcare System: A Qualitative Investigation

OBJECTIVE

Patients with severe health anxiety have complex interpersonal relationships with medical providers and others in their social context, often resulting in conflictual interactions with providers and perception of poor medical care. An adequate understanding of the causes and consequences of these interactions is lacking, particularly 1 informed by the experience of the patient. This study used qualitative methods to explore the development and maintenance of health anxiety from the perspective of patients with lived experience of coping with health anxiety and their interactions with the healthcare system.

METHOD

We conducted qualitative interviews with 11 primary care patients purposely sampled to describe their experience living with health anxiety, provider interactions, and social and family interactions surrounding health and health anxiety. We extracted themes related to living with health anxiety and interactions with providers and other significant relationships.

RESULTS

Thematic content analysis revealed 5 themes including 3 causal themes, 1 response theme, and 1 theme reflecting factors that mitigate health anxiety. Causal themes included subthemes reflecting predisposing factors of the self, key stimulus events from patient learning history, and maladaptive social interaction factors. The response theme was comprised of 2 subthemes: logical conclusions and health anxiety symptoms. The mitigating factors theme included subthemes of a trusting care relationship and recognition of disconfirming evidence.

CONCLUSION

The themes and constituent subthemes identified in this study largely map onto cognitive-behavioral theory of health anxiety, demonstrating alignment between patient experience and theory. The resulting model also identifies potential points of intervention in the developmental and maintenance process. We provide recommendations to maximize those points of intervention.

Identifying the Effect of Digital Healthcare Products in Metaverse on Mental Health: Studying The Interaction of Cyberchondria and Technophobia

Objectives: Metaverse has emerged as an innovative social media platform and Internet applications which integrates several cutting-edge technologies. It possesses connectedness, hyper spatio-temporality, and several technology attributes. The metaverse also can potentially reinvent health's digital and practical prospects, much as the Internet drastically changed that industry. Major ramifications will follow for both our well-being and the provision of healthcare. In China, after the emergence of the pandemic, there is a substantial need for digital healthcare services since the interaction between hospitals and people requiring consultation is minimal. The current study will examine the impact of digital healthcare products in the metaverse on mental health while considering the moderating effect of cyberchondria and technophobia. The need for more resources and increased demand for healthcare services creates difficulty in promptly delivering services to the needy. Metaverse and its technology can improve the performance of the current healthcare system. Methods: The research utilized a quantitative survey- based method in the healthcare sector among staff members. Of 330 questionnaires distributed, 307 were collected and analyzed through SPSS and AMOS. Results: The analysis signified a strong and significant association between digital healthcare products and mental health in the metaverse, along with the considerable moderation of technophobia. Conclusion: The paper can improve healthcare sector staff members' provision practices and mental health. It can provide cost-effective solutions to the sector.

Cyberchondria, Anxiety Sensitivity, Hypochondria, and Internet Addiction: Implications for Mental Health Professionals

Repetitive online searches for health information increase anxieties and result in Internet addiction. Internet addiction, cyberchondria, anxiety sensitivity, and hypochondria have been studied separately, but how these concepts are reciprocally linked has not been investigated. This study aimed to determine the levels, correlations, and predictors of Internet addiction, cyberchondria, anxiety sensitivity, and hypochondria among students based on the sample's characteristics. A sample of 143 university students participated in this cross-sectional online survey. A self-reported questionnaire was employed to collect data from students. The studied concepts had moderate to high correlations with each other and with the students' characteristics. Not getting infected with the coronavirus was among the demographic factors inserted into the regression model that only predicted cyberchondria. The model of cyberchondria was significant and explained 11.5% of the variance in the score of concepts. The results of the standard regression analysis indicated that the model predicting Internet addiction accounted for 41.2% of the variability. Our unique findings indicate that cyberchondria can contribute to developing Internet addiction compared to earlier studies. The findings suggest the importance of empowering students to overcome their anxieties by managing cyberchondria and Internet addiction. Mental health professionals, namely psychiatric nurses, are at the forefront of taking preventive mental health measures on campus, such as screening and referring students who exhibit these problems to psychological support and counseling to cope with their anxieties.

The role of base-rate neglect in cyberchondria and health anxiety

Cyberchondria is characterized by excessive health-related online search behavior associated with an unfounded escalation of concerns about common symptomatology. It often co-occurs with health anxiety. We investigated whether base-rate neglect-the cognitive bias to ignore a priori probabilities (e.g., of serious diseases)-plays a significant role in cyberchondria and health anxiety. 368 participants were randomly assigned to eight experimental conditions, manipulating the base-rate (30 % vs. 70 %), the judgment domain (health-neutral versus health-related), and the salience of base-rate information (low vs. high) in a 2×2×2 between-subjects design when asking them for probability judgments with versus without disease relevance. We found that high salience decreased base-rate neglect in participants with low, but not in those with elevated levels of either cyberchondria or health anxiety. Under low salience conditions, however, both cyberchondria and health anxiety severity were uncorrelated with base-rate neglect. These effects were independent of whether health-related or health-neutral problems were evaluated. Our findings suggest a domain-general probabilistic reasoning style that may play a causal role in the pathogenesis of cyberchondria and health anxiety.

Online Symptom Checkers are Poor Tools for Diagnosing Men's Health Conditions

OBJECTIVE

To analyze the accuracy of the four most commonly used online symptom checkers (OSCs) in diagnosing erectile dysfunction (ED), scrotal pain (SP), Peyronie's disease (PD), and low testosterone (LT).

METHODS AND OUTCOMES

One-hundred and sixty artificial vignettes were created by de-identifying recent initial outpatient consults presenting to discuss ED (40), SP (40), PD (40), and LT (40). The vignettes were entered into the 4 most frequently used OSCs (WebMD, MedicineNet, EverydayHealth, and SutterHealth) as determined by web traffic analysis tools. The top 5 conditions listed in the OSC differential diagnosis were recorded and scored.

RESULTS

WebMD's accuracy for ED, SP, PD, and LT vignettes was 0%, 22.5%, 0%, and 95%, respectively. EverydayHealth was only able to diagnose SP 20% of the time, and failed to diagnose ED, PD, or LT on all occasions. MedicineNet diagnosed ED, PD, SP, and LT in 100%, 98%, 27.5%, and 0% of vignettes, respectively. SutterHealth correctly diagnosed ED, SP, and LT in 100%, 20%, and 80% of patients, respectively. Cumulatively, the OSCs were most accurate in diagnosing ED and least accurate in diagnosing SP when using the Top 1 (37.5% vs. 6.9%) and Top 5 (50% vs. 24.5%) of the suggested conditions.

CONCLUSIONS

No OSC could accurately diagnose all the conditions tested. The OSCs, on average, were poor at suggesting precise diagnoses for ED, PD, LT, SP. Patients and practitioners should be cautioned regarding the accuracy of OSCs.

The Doctor Is In(ternet): The Mediating Role of Health Anxiety in the Relationship between Somatic Symptoms and Cyberchondria

Cyberchondria is a dysfunctional behavioral pattern characterized by an excessive and anxiety-amplifying engagement in searching for reassuring health information on the Internet. Research demonstrated that somatic symptoms and health anxiety might foster maladaptive health-related behaviors, such as cyberchondria. However, the relationships between somatic symptoms, health anxiety, and cyberchondria have been scarcely examined. Accordingly, this study aimed to test the mediating effect of health anxiety on the association between somatic symptoms and cyberchondria. Four hundred and thirty-one adults from the community (158 males, 36.66%), aged between 18 and 74, were recruited via an online survey. Participants completed self-report measures of somatic symptoms, health anxiety, and cyberchondria. A mediation analysis demonstrated that the severity of somatic symptoms predicted increased levels of cyberchondria and that health anxiety partially mediated this association. Therefore, interventions aimed at decreasing health anxiety may also play a role in decreasing the risk of developing cyberchondria.

Internet Derived Information Obstruction Treatment (IDIOT) Syndrome: A Breviloquent Review

The rapid increase in internet use in the current digital era has caused a potential increase in anxiety, and a person either self-medicates or abruptly stops the drug for his medical illness, thereby the rise in the Internet Derived information Obstructing Treatment (IDIOT) syndrome. The Internet Derived Information Obstructing Treatment (IDIOT) syndrome occurs when patients abruptly quit their treatment because they have blindly trusted internet medical information. WHO calls this an " Infodemic," which has created a complex situation in healthcare, as it has caused too much information in digital and physical environments during an outbreak of the disease and caused mistrust in health authorities. Patients get important health information online and anticipate additional assistance, Dr. C. N. Manjunath, Director, Jayadeva Hospital, says “Doctors are becoming sick because of stress, and they need to take care of their health. There is an added demand to ac­q­u­ire communication skills rather than merely technical and professional qualities.” Patients must not merely believe healthcare-related information available from online health resources and must seek the help of licensed healthcare professionals for their health concerns. There must be an increase in the awareness programs among the public to as not to fall as victims and blindly follow or abruptly stop their medical prescriptions for their medical illness from available online health resources.

COVID-19 Information-Seeking, Health Literacy, and Worry and Anxiety During the Early Stage of the Pandemic in Switzerland: A Cross-Sectional Study

Objectives: To describe COVID-19 information-seeking behavior (CISB) during the first stage of the pandemic in Switzerland and identify its determinants.

Methods: We conducted an online cross-sectional survey (4 May to 6 July 2020). Participants self-reported their CISB (information sources and frequency), personal COVID-19 situation (e.g., perception about having had COVID-19), sociodemographic information, and completed validated measures of health literacy, and worry and anxiety. Data were analyzed using descriptive statistics and logistic regressions.

Results: We included 1,505 participants (24.7% male; mean age = 43.0 years, SD = 13.9). Most participants reported searching for information daily (n = 1,023, 68.0%) and referring to multiple information sources (mean 3.7, SD = 1.5). Commonly used sources were official websites (n = 1,129, 75.0%) and newspapers (n = 997, 66.2%). Participants with higher health literacy were more likely to seek information daily and use online resources, but less likely to use personal networks than those with lower health literacy. We did not find any association between CISB and worry and anxiety.

Conclusion: More opportunities for personal dialogue and education about reliable online information resources should be encouraged to optimize the CISB of groups with lower health literacy.

From idioms of distress, concern, and care to moral distress leading to moral injury in the time of Covid

In this invited commentary on the thematic issue of Transcultural Psychiatry on idioms of distress, concern, and care, I provide a brief overview of how my research agenda evolved over the years while conducting community and clinic-based research in South and Southeast Asia as well as North America. I then suggest areas where future research on idioms of distress, concern, care, and resilience will be needed among different demographics given social change and shifts in how we communicate face to face and in virtual reality, the impact of medicalization, pharmaceuticalization and bracket creep, changes in indigenous healing systems, and hybridization. I further call attention to the importance of conducting idioms guided research in occupational settings. Toward this end I highlight the moral distress health care workers in the U.S. have experienced during the Covid-19 pandemic and point out the importance of differentiating individual burnout from moral injury related to structural distress. I conclude by discussing the general utility of an idioms of distress perspective in the practice of cultural psychiatry and suggest that this perspective needs to be included in the training of all practitioners regardless of the system of medicine they practice. Doing so may enable the formation of mental health communities of practice in contexts where there are pluralistic health care arenas.

Investigating the Obsessive and Compulsive Features of Cyberchondria: A Holistic Review

Background

Cyberchondria has been brought into sharp focus during the COVID-19 health emergency; it refers to individuals who obsessively and compulsively search for health information online, resulting in excessive health concerns. Recent scholarship focuses on its obsessive and compulsive aspect, following a biopsychosocial approach as opposed to a pathology of health anxiety. It lacks interpretation of the socio-psychological dynamics between the dimensions.

Objective

This review aims to propose a holistic view toward understanding cyberchondria as an obsessive–compulsive syndrome and considers possible interventions. It specifically seeks to explain cyberchondria from diversified mediator variables and to pinpoint connections between each perspective.

Methodology

Comprehensive searches of databases such as PubMed and Springer were conducted to identify English articles relating to cyberchondria from 2001 to 2022. Based on a systematic filtering process, 27 articles were finally reviewed.

Findings

The authors compare and confirm three forecasts to predict cyberchondria, associating it with individual metacognition, uncertainty of unverified information, and algorithm-driven, biased information environments.

Value

Theoretically, a holistic framework is proposed to explain the obsessive and compulsive features of cyberchondria. Clinically, the research calls for more professional psychoeducation and chain screening of cyberchondria and other psychological disorders. Socially, it promotes support for risk-sensitive, information-deficient groups during pandemics like COVID-19. It also stresses more careful use of algorithm-driven search engine technology for platforms delivering medical information. Future research may explore areas such as the association between cyberchondria and other social-related disorders, as well as correlations among cyberchondria, obsessive and compulsive disorders, medical trust, and algorithm-driven search results.

A preliminary investigation of Cyberchondria and its correlates in a clinical sample of patients with obsessive-compulsive disorder, anxiety and depressive disorders attending a tertiary psychiatric clinic

Objectives. This cross-sectional study aimed to investigate the frequency and presentation of cyberchondria (CYB) in patients with obsessive-compulsive disorder (OCD), anxiety disorders (ADs), and major depression disorder (MDD).Methods. Seventy-seven patients (OCD:25, ADs:26, MDD:26) referred to a tertiary psychiatry outpatient clinic and 27 healthy controls (HCs) were included. A 'working' definition of CYB was used to measure CYB frequency. CYB severity was measured with the Cyberchondria Severity Scale (CSS).Results. CYB as currently defined was present in just 1.3% of the combined patients' sample. Using a broader definition (omitting the disability criterion), we found a higher distribution (OCD:12%, ADs:19.2%, MDD:15.4%, HCs:3.7%) and greater CYB symptom severity. Patients with OCD (63.3 ± 18.9) and ADs (63.3 ± 25.9) showed a higher CYB severity, compared with HCs (48.4 ± 9.9, p<.05). In the combined patients' sample, a positive correlation was found between the CSS scores and measures of health anxiety or hypochondriasis. Higher CYB symptom severity emerged in patients with a positive family history of psychiatric disorders and in those prescribed benzodiazepines or mood-stabilisers.Conclusion. CYB represents a common transdiagnostic syndrome in patients with OCD, ADs, and MDD with a spectrum of severity and indicates a variable burden of illness, supporting the need for specific clinical considerations and interventions.Key pointsCyberchondria (CYB) represents a common transdiagnostic syndrome in patients with obsessive-compulsive disorder, anxiety, and depressive disorders.CYB's frequency as a syndrome of compulsive online health searches associated with an increased anxiety and distress was reported in 10-20% patients.Health anxiety/hypochondriasis showed a strong correlation with CYB.Patients with a positive family history of psychiatric disorders and those prescribed benzodiazepines or mood-stabilisers showed higher CYB symptom severity.Considering the spread of Internet use for health-related information, additional studies investigating CYB in clinical samples are encouraged.

The Spanish version of the short form of the Cyberchondria Severity Scale (CSS-12): Testing the factor structure and measurement invariance across genders

Cyberchondria refers to excessive and repeated online health-related searching, which is associated with increased distress and anxiety. The Cyberchondria Severity Scale (CSS) is the most widely used measure for assessment of cyberchondria, and its shortened version (CSS-12) has recently been developed. The aim of the present study was to develop the Spanish version of the CSS-12 and test its psychometric properties. A community sample of 432 Spanish-speaking adults (67.6% women; mean age = 36.00 ± 15.22 years) completed the Spanish translation of CSS-12 along with measures of health anxiety, obsessive-compulsive, anxiety and depressive symptoms. The Spanish version of the CSS-12 comprises a general cyberchondria factor and four specific factors (‘excessiveness’, ‘compulsion’, ‘distress’, and ‘reassurance’). Multi-group confirmatory factor analysis indicated measurement invariance across gender groups. Internal consistency values for the total score and subscales were good to excellent. The CSS-12 showed strong correlations with health anxiety, and moderate to low correlations with anxiety, obsessive-compulsive and depressive symptoms, supporting the convergent and divergent validity of the CSS-12, respectively. In conclusion, these results show that the CSS-12 is a valid and reliable tool for measuring cyberchondria in both genders in the general Spanish population.

The effect of cyberchondria on anxiety, depression and quality of life during COVID-19: the mediational role of obsessive-compulsive symptoms and Internet addiction

Since the global pandemic of the coronavirus disease 2019 (COVID-19), online health information-seeking behaviors have notably increased. Cyberchondria can be a vulnerability factor for the worsening of anxiety-depressive symptoms and quality of life. The current study aims to understand the predictive effect of cyberchondria on health anxiety, anxiety, depression and quality of life considering the mediating effect of obsessive-compulsive symptoms and Internet addiction and the moderating effect of COVID anxiety. 572 Italian participants (66% female; Mean age = 34; SD = 15) took part in a cross-sectional online survey involving CSS-12, MOCQ-R, IAT, SHAI, HADS, WHOQoL-BREF and CAS. Mediation and moderation analyses were conducted. Obsessive-compulsive symptoms and Internet addiction were found to partially mediate the cyberchondria-health anxiety and the cyberchondria-anxiety links and to totally mediate the cyberchondria-depression and the cyberchondria-quality of life links. COVID anxiety was found to moderate the relationship between cyberchondria and anxiety. The findings suggest that compulsivity may have a key role in the explanation of the underlying mechanisms of cyberchondria. Healthcare practitioners should provide additional support for individuals with cyberchondria. As such, cyberchondria is a contributing factor to the exacerbation of anxiety-depressive disorders and may impact on the quality of life.

Does cyberchondria predict Internet addiction among students during the COVID-19 pandemic? A web-based survey study

BACKGROUND

Previous literature has investigated the association of this phenomenon and Internet addiction. Nevertheless, little research has been conducted to elucidate the predictive associations among these concepts among students.

OBJECTIVE

This study reported students' cyberchondria and Internet addiction, and it examined whether cyberchondria predicts Internet addiction.

MATERIAL AND METHODS

During the COVID-19 pandemic, cross-sectional data were collected using a web survey from a convenience snowball sample of 143 students enrolled in e-learning courses at a governmental university.

RESULTS

A moderate level of cyberchondria and a mild level of Internet addiction was evident among students. A moderate level of cyberchondria and a mild level of Internet addiction was evident among students. Moderate to high significant correlations were reported among the studied concepts and with the sample's characteristics. Cyberchondria and unavailability of the Internet at school were predictors of Internet addiction.

IMPLICATIONS

Healthcare providers, including nurses, should provide information that preserves students' mental health during stressful periods such as the COVID-19 pandemic and should offer clear instructions on stress and anxiety management during such times. A longer scale, especially for cyberchondria, is warranted in future research with a random and larger sample.

CONCLUSIONS

Findings suggest that cyberchondria serves as a predictor of Internet addiction, contrary to findings of previous studies. Various psychosocial interventions should always be initiated to help students prevent or address cyberchondria and Internet addiction.