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

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.

The Moderating Role of Health Literacy and Health Promoting Behavior in the Relationship Among Health Anxiety, Emotional Regulation, and Cyberchondria

Background

People are increasingly turning to the internet to find answers to their health concerns in an era where there is a wealth of online health information, which frequently causes increased health anxiety and the phenomenon known as cyberchondria. The objectives of this study were to examine the moderating role of health literacy and health promotion behavior and the mediating role of emotional regulation between health anxiety and cyberchondria among the Pakistani population.

Methods

The study used a self-administered questionnaire to collect and examine health anxiety, emotional regulation, health literacy, health promotion behavior, and cyberchondria in 755 residents. A moderated mediation model of Hayes PROCESS was used to examine this hypothesis.

Results

The findings unveiled the average score of the participants on the study variables, as well as their categorization into low, moderate, and high categories. On scale of Health Anxiety participant scores (32% vs 53% vs 15%), Emotional Regulation (25% vs 46% vs 29%), Cyberchondria (18% vs 41% vs 41%), Health Literacy (56% vs 29% vs 15%), and Health promotion Behavior (49% vs 28% vs 23%). Moreover, result revealed that emotional regulation mediates the significant positive association between health anxiety and cyberchondria (β=0.25**p<0.001). Furthermore, health literacy moderates the negative association health anxiety and emotional regulation (β=-0.42*p<0.031), and health promotion behavior also negatively moderate the relationship between emotional regulation and cyberchondria (β=-0.27*p<0.22).

Conclusion

Based on the findings, it is recommended that health policymakers consider comprehensive national initiatives that focus on educational planning. These initiatives should boost health literacy levels and promote health-related behavior. Additionally, there is urgent need for strict measures to be put in place for monitoring online platforms and websites that spread inaccurate or false health-related information.

COVID-19 era-related e-learning: a cross-sectional web-scale study of cyberchondria, internet addiction and anxiety-related symptomatology among university nursing students

OBJECTIVE

The study assessed COVID-19 era-related e-learning cyberchondria, internet addiction and anxiety-related symptomatology among nursing students. The relationships, predictors and differences between the studied concepts were measured.

DESIGN

In 2021, a quantitative cross-sectional research design using a web survey with a sample size of 333 nursing students yielded a response rate of 70%.

RESULTS

Nursing students had a moderate level of cyberchondria, low to moderate internet addiction, a moderate to severe level of anxiety and depression, and a normal stress level. Demographic characteristics, cyberchondria, internet addiction and anxiety-related symptomatology were significantly correlated. Grade point average, age, type of organisation where the students were trained and level of education were significant predictors of the studied variables. Significant differences in the studied concepts were found based on the sample's characteristics such as gender, type of organisations or universities where the students were trained or studied, and age.

CONCLUSION

Cyberchondria, internet addiction, depression, anxiety and stress symptomatology are troublesome. Higher education organisations might benefit from examining the variables of interest and investigating the relations between internet addiction and depression and anxiety symptomatology among nursing students. Such research will aid in tailoring treatments to assist vulnerable students by targeting counselling and educational efforts toward building a future generation of nurses with reduced cyberchondria, internet addiction and anxiety-related symptomatology.

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.

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.

How cyberchondria and decision self-efficacy shapes the acceptability of COVID-19 vaccine: A gender-based comparison

Objective

Alarmingly, the individuals' reach and coverage to get vaccinated in developing regions during the pandemic is a massive challenge for concerned authorities. This study aimed to demonstrate how cyberchondria play a significant role in a classical health belief model. Cyberchondria may influence cognitive factors (e.g. self-efficacy), which may contribute to an increase in attitude-behavior gap. Especially in the context of a health-centric scenario, it may discourage individuals to take protective measures.

Method

By using the cross-sectional research design, the authors conducted a quantitative survey in Pakistan and collected 563 responses from 303 male respondents (rural = 91; urban = 212) with (Urban M:35.5, standard deviation (SD):13.4) and rural M:37.5, SD:8.4).

Result

The findings indicate that decision self-efficacy among males is stronger than that in females. It dominates other determinants, which can dampen the individuals' intentions to get vaccinated. For instance, the effect of conspiracies and perceived seriousness was noted nonsignificant and weak. In females, perceived seriousness was stronger determinant than in males. In addition, the negative effect of decision self-efficacy was noted in the case of females, and conspiracy and cyberchondria had a negative role.

Conclusion

This study highlights valuable implications for future research in infodemic, health communication and health literacy, and practical implications for regulatory bodies and public administration.

Digitalization and Urological Diseases: Severity of Cyberchondria and Level of Health Anxiety in Patients Visiting Outpatient Urology Clinics

This study aimed to evaluate the cyberchondria levels of patients who applied to the urology outpatient clinic. The second goal of this study was to evaluate the relationship between cyberchondria severity and health anxiety in these patients. The present prospective observational study was conducted at the urology outpatient clinic of two tertiary centers in our city between September and December 2021. Eligible patients were the adult patients (>18 and ≤60 years) who used the Internet for health purposes and had no self-reported psychological or mental disease. The patients were divided into following groups according to their complaints: general urology, uro-oncology, andrology, functional urology, and endourology (stone disease). The level of cyberchondria and health anxiety was evaluated for these patients by using the Short Health Anxiety Inventory (SHAI) and a short-form version of the Cyberchondria Severity Scale (CSS-12). This study enrolled 578 patients (190 female, 388 male). The mean age of patients was 43.4 ± 13.3 years (18-60 years). The mean CSS-12 was 28.1 ± 12.1, and the mean value of SHAI was 18.9 ± 13.6. The patients had andrological symptoms, is uniquely related to higher CSS and health anxiety, and followed by uro-oncological diseases. However, the least relationship was observed in patients with functional urological diseases (analysis of variance [ANOVA], p < 0.001 for CSS-12; p < 0.001 for SHAI). In addition, a positive correlation was observed between the CSS and SHAI (Pearson's correlation = 0.782). The increased level of cyberchondria causes increased health anxiety and an increased disease burden in these patients. Therefore, physicians should consider this increased treatment burden during the treatment of patients.

Social Support Mediates the Association between Health Anxiety and Quality of Life: Findings from a Cross-Sectional Study

This study aimed to test if perceived social support and cyberchondria mediate the association between health anxiety and quality of life (QoL) in a nonclinical sample. Cross-sectional research involved adult internet users (n = 538) between 16 May 2020 and 29 December 2020 in Poland who completed self-report questionnaires, including the cyberchondria severity scale (CSS-PL), the short health anxiety inventory (SHAI), the multidimensional scale of perceived social support (MSPSS) and the quality of life scale (QOLS). A mediation analysis was performed to examine the direct effects of health anxiety on cyberchondria, perceived social support and quality of life. Likewise, the effects of cyberchondria and perceived social support on QoL were analyzed. Hence, indirect effects of health anxiety on QoL through cyberchondria and perceived social support were explored. Health anxiety significantly impaired QoL both directly and indirectly through low-perceived social support. Perceived social support partly mediated the association between health anxiety and QoL. Cyberchondria did not have a significant direct effect on the latter. Thus, cyberchondria did not mediate the relationship between health anxiety and QoL. Boosting-perceived social support may mitigate the detrimental effect of health anxiety on QoL. Cyberchondria was not found to have a significant effect on QoL in contrast to health anxiety alone.

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.