The Internet has become the primary source of health information, which is typically obtained through online health searches using relevant engines, a behavioral pattern also known as “Dr. Google" . Online health searching has had an empowering effect, allowing easy access to hitherto hard-to-find health information. However, it can also become problematic and lead to cyberchondria.
Cyberchondria is excessive and/or repeated online health searching that is associated with increased health distress or anxiety and persists despite interference with functioning and negative consequences. The latter may include disruptions in relationships with physicians and in habitual patterns of seeking and receiving medical care.
It has been suggested that cyberchondria represents a compulsive form of “problematic Internet use”, the key issue being poor control over online health seeking. This search is driven by the need to alleviate health anxiety, which however increases with persistent search and then spirals out of control. Studies have confirmed strong relationships between cyberchondria and health anxiety, problematic Internet use, and symptoms of obsessive-compulsive disorder.
Preventing cyberchondria may involve improving online health information literacy, as people with higher literacy have been found to have lower levels of cyberchondria. A targeted approach to prevention requires addressing factors that increase the risk of cyberchondria, including erroneous expectations of the Internet, mismanagement of information overload, uncertainty, and confusion about the reliability of online health information sources. .
A prevention program first needs to clarify what the Internet can and cannot do.
It is important to debunk unrealistic expectations, for example, that the Internet can provide definitive explanations for all health-related queries. The accumulation of information does not necessarily translate into better understanding or more knowledge. In the context of online health search, having more information is not the same as also having an explanation, for example, a diagnosis. Trying to self-diagnose yourself through Dr. Google should be discouraged as it can get out of hand, cause further distress, and therefore lead to cyberchondria.
Second, a large amount of online health information (information overload) during online health searching, especially when that information is inconsistent or conflicting, can lead to a feeling of being "stuck" or losing control while searching. perform the search. Providing education about the effects of information overload and improving management of this overload can provide protection against cyberchondria.
Third, proper uncertainty management can also play an important role in preventing cyberchondria. Online health information is often ambiguous and can be confusing, increasing uncertainty. Intolerance of such uncertainty and attempting to cope with it through further seeking to reach “closure” (e.g., a diagnosis) paves the way toward a vicious cycle of seeking reassurance. Therefore, if online health seeking does not progress and appears to generate only distress, the strategy should change and relevant health information should be obtained from an alternative source, including the doctor.
Fourth, the ability to distinguish between trusted and untrustworthy sources of online health information provides an additional layer of security when conducting an online health search. Health information obtained from reputable sources (e.g., academic and research organizations or governments) is often more reliable, although it may be “impersonal.” Health information found on forums and blogs often reflects personal experience and may be valuable as such, but is not necessarily applicable to others.
People with cyberchondria do not usually seek help directly, perhaps due to the perception that it is not a “recognized” condition. Instead, they tend to present to clinical services with hypochondriasis, anxiety disorders, problematic Internet use, or even “Internet addiction.” Largely due to the ambiguous conceptual status of cyberchondria and its relatively “hidden” nature, approaches to its management are still in their infancy.
Management of cyberchondria should be based on understanding each person’s circumstances. In other words, why is that person experiencing cyberchondria at this particular time? What precipitated cyberchondria and what is its purpose? Is it a specific symptom or health issue that started the online health search and is the person primarily looking for reassurance? What are the consequences of cyberchondria and how has one’s life changed due to excessive online health seeking? For example, has the person been avoiding their doctor or visiting them too frequently? Why does excessive online health searching persist despite the problems it has caused? Is it because the search is experienced as a way of facing uncertainty? The answers to these questions are likely to shape the management approach and determine treatment goals.
Common treatment targets in cyberchondria include certain facets of psychopathology (e.g., health anxiety and obsessive-compulsive symptoms), personality traits (e.g., perfectionism, trust/distrust imbalance, intolerance of uncertainty and poor time management), behavioral responses to anxiety-provoking situations. or distressing stimuli (e.g., comfort seeking or avoidance), information management problems (e.g., poor handling of abundant or conflicting online health information), and specific aspects of interactions with computers and the Internet (e.g., unrealistic expectations of the Internet or assumption that the order in which online health search results are presented reflects the likelihood that these results provide an explanation for health-related queries) These goals can be addressed using a combination of educational and psychotherapeutic approaches.
Existing psychotherapeutic methods can be adapted to treat cyberchondria. One study has shown that a modified Internet‐delivered cognitive behavioral therapy (CBT) for hypochondriasis/health anxiety that also addressed cyberchondria was effective in treating both 6 . In that study, the cyberchondria-specific components of CBT included measures that improved online health information literacy and psychoeducation on ways to make searching productive and avoid excessive and unnecessary searching.
Cyberchondria is increasingly considered a public health problem that is solely and primarily related to its potential to impact healthcare. Given this recognition, the development of prevention and management programs for this condition and the testing of their effectiveness should be prioritized.
