Science Vs. Myth
Inside the Mind
What is cyberchondria?
by Emilie Sennebogen
Browse the article What is cyberchondria?
Your dog might be a hypochondriac, but at least he doesn't have Internet access. See more mental disorder pictures.
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You gorged yourself on a huge meal and an hour later you're having some weird cramping pains in your chest. You head over to your computer and type the symptom "chest pain" into your preferred search engine. The first result to pop up is -- heart attack? Your curiosity escalates into anxiety as you scroll through pages that list heart attack symptoms as the exact ones you're having. More than likely, what you're experiencing isn't a heart attack at all -- it's the phenomenon of cyberchondria.
The term cyberchondria has come into use in the Internet age, and depending on whom you ask, you may get conflicting information about what characterizes this condition. In 2000, a journalist at the London Sunday Times defined cyberchondria as "the deluded belief you suffer from all the diseases featured on the [I]nternet." In 2001, a BBC News article referred to cyberchondria as "[I]nternet print out syndrome." Dr. Brian Fallon of Columbia University, a leading researcher on hypochondria, defines cyberchondriacs as "a group of hypochondriacs who have a strong, obsessive compulsive focus to their symptoms." He claims that 90 percent of hypochondriacs who have access to the Internet become cyberchondriacs [source: ABC News].
­Research studies have sought to redefine the characteristics of cyberchondria, moving away from the hypochondria aspect and focusing on the behavior of researching health-related information online. According to Harris Interactive, a U.S.-based market research company that has conducted several studies on cyberchondria, the word hypochondria means "excessive concern about health." By this definition, cyberchondria literally means "online concern about health" and isn't meant to have the derogatory connotation that is implied with hypochondria.
In the next section, we will take a look at how search engine results impact cyberchondria.
Microsoft Examines the Causes of Cyberchondria
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Say you're having muscle twitches and you enter this symptom into a general Web search. One of the first results that comes up might be ALS, which is a serious degenerative disease that affects nerve cells in the brain and the spinal cord. Based on the results generated by the search engine, your anxiety causes you t­o focus on researching ALS, derailing you from finding information about a more probable and less harmful cause, such as muscle strain.
­In 2008, a comprehensive study on cyberchondria and search engines was completed by Microsoft researchers Ryen White and Eric Horvitz. White and Horvitz concluded that when a Web search is used to diagnose a symptom, it has the potential to increase the anxieties of users who don't have proper medical training or education. They used the term escalation to describe this increase in anxiety. They also found that search engine results could lead to unnecessary doctor visits, resulting in a waste of time and money.
People tend to focus on the first couple of results rather than looking through all of their options -- or considering that, unlike their physician, Dr. Google doesn't factor in important things like age, health background and family history to the diagnosis.
In one aspect of the study, the researchers surveyed 500 Microsoft employees about their experiences in searching for health-related information on the Web. Nine out of 10 said that a Web search for basic medical information had led to researching a more serious condition. This was a surprising discovery, given that none of the participants described themselves as having excessive health concerns.
Another important finding in this study was that many of the participants seemed to think that search engines ranked the results of their searches according to the likelihood of having a particular disease. In actuality, search engines use mathematical algorithms that rank pages and turn up results based on factors such as how many times a keyword is mentioned, how many clicks a page receives and how many links there are on a page. This creates a situation where worried users click on a page containing information about a rare illness which in turn drives the page rank up, increasing the likelihood that another worried user will come across that page as well.
­White and Horvitz concluded that search engine architects have a responsibility to improve search and navigation procedures to ensure that results related to health inquiries are less anxiety inducing. They acknowledge that this presents "algorithmic challenges" and are pursuing the creation of classifiers that will help indicate when someone is attempting to use a search engine to diagnose a symptom.
In the next section, we'll talk about how taking Internet research to your doctor could affect your doctor-patient relationship.
The Impact of the Internet on Doctor-Patient Relationships
What should you do when your doctor doesn't want to listen?
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­Traditionally, the doctor-patient relationship has been one in which the doctor is the main source of information about a patient's diagnosis and treatment. This standard is altered when patients seek to inform themselves via the Internet and wish to act as more of a partner in their own care. The change has been met with some resistance from the physician community, since the information found on the Internet is often unreliable. The Microsoft study found that many participants largely ignored the source of the information they found, focusing instead on the information itself. Information on the Internet isn't regulated, which can create a challenge for doctors treating misinform­ed patients who believe what they read on the Internet instead of their doctor's opinion. In addition, the limitations of insurance can result in a lack of financial compensation to the physician for the additional work that a patient armed with a sheaf of Internet printouts can create.
More progressive physicians believe that the Internet offers opportunities to improve the doctor-patient relationship by having the patient share the responsibility for his or her care. Smarter patients equal better patients. A Harris online poll found that patients who use the Internet to search for information about their health are more likely to ask informed questions and are more likely to comply with their prescribed treatment.
Dr. Jared Dart, an Australian health consultant, offers a suggestion for maintaining a positive doctor-patient relationship: Health professionals should prescribe information as they would medication, in order to keep the Internet a way to manage health information instead of a self-diagnosis tool. In the meantime, here are some tips to increase the likelihood of getting the credible health information that you seek:
Rather than using general search engines such as Google, try a health-related search engine with symptom checker components.
Look for information on nonprofit health sites in the United States, such as the Center for Information Therapy and Healthwise, or government sites in the U.K. such as the National Health Service.
Search for information on specialty sites created by well-funded medical research charities, such as the American Cancer Society or Cystic Fibrosis Foundation.
Ask your doctor for credible Web sites where you can more thoroughly research your diagnosis or symptoms.
If Internet search results leave you feeling perpetually anxious about your health, make an appointment to see a health care provider.
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More Great Links
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ABC News. "For Cyberchondriacs, Internet is the Enemy. " May 19, 2007. http://abcnews.go.com/gma/oncall/Story?id=3190086&page=1
Akerkar, Shashank M and Bichile, LS. "Doctor patient relationship: Changing dynamics in the information age." Journal of Postgraduate Medicine, Volume 50, Issue 2 - Professional Journal. Medknow Publications, 2004, pp 120-122.http://www.jpgmonline.com/article.asp?issn=0022-3859;year=2004;volume=50;issue=2;spage=120;epage=122;aulast=Akerkar
BBC News World Edition. "Cyberchondria Hits Web Users," April 13, 2001. http://news.bbc.co.uk/2/hi/health/1274438.stm
Bourke, Emily. " Patients go online but don't trust the info." The World Today, Tuesday, August 5, 2008.http://www.abc.net.au/worldtoday/content/2008/s2324607.htm
Friedewald, Vincent E. "The Internet's Influence on the Doctor-Patient Relationship - Internet/Web/Online Service Information." Health Management Technology, Nelson Publishing, November 2000. http://findarticles.com/p/articles/mi_m0DUD/is_11_21/ai_67373716
Health Care News, Volume 2, Issue 12 - professional journal. "4-Country Survey Finds Most Cyberchondriacs Believe Online Health Care Information is Trustworthy, Easy to Find and Understand." Harris Interactive, Inc., June 11, 2002.
Purcell, Gretchen P, Wilson, Petra and Delamothe, Tony. "The Quality of Health information on the Internet." BMJ, Volume 324- Professional Journal. BMJ Group, March 9, 2002, pp. 557-558.
Rogers, Lois. "The internet addicts who give their GP a headache." London Sunday Times, April 2, 2000.
Sansom, Claire. "A Cure for Hypochondria." Regulars - Professional Journal. The Biochemical Society, December 2007, p. 34
Segilman, Katherine. "Imaginary maladies online Internet spreads 'cyberchondria.'" , San Francisco Chronicle, February 15, 2004.http://www.sfgate.com/cgi-bin/article.cgi?file=/chronicle/archive/2004/02/15/LVGIU4R1OP1.DTL
White, Ryen W. and Horvitz, Eric. "Cyberchondria: Studies of the Escalation of Medical Concerns in Web Search." Microsoft Research, pp 1-32.