Cyberchondria

Cyberchondria, otherwise known as 'compucondria', the unfounded escalation of concerns about common symptomology based on review of search results and literature online. Articles in popular media position cyberchondria anywhere from temporary neurotic excess to adjunct hypochondria. Cyberchondria is a growing concern among many healthcare practitioners as patients can now research any and all symptoms of a rare disease, illness or condition, and manifest a state of medical anxiety.

The term "cyberchondria" is a portmanteau neologism derived from the terms cyber- and hypochondria. (The term "hypochondrium" derives from Greek and literally means the region below the "cartilage" or "breast bone.") Researchers at Harris Interactive clarified the etymology of cyberchondria, and state in studies and interviews that the term is not necessarily intended to be pejorative.

A review in the British Medical Journal publication Journal of Neurology, Neurosurgery, and Psychiatry from 2003 says cyberchondria was used in 2001 in an article in the United Kingdom newspaper The Independent to describe "the excessive use of internet health sites to fuel health anxiety." The BBC also used cyberchondria in April, 2001. The BMJ review also cites the 1997 book from Elaine Showalter, who writes the internet is a new way to spread "pathogenic ideas" like Gulf War syndrome and myalgic encephalomyelitis. Patients with cyberchondria and patients of general hypochondriasis often are convinced they have disorders "with common or ambiguous symptoms."

The first systematic study of cyberchondria, reported in November 2008, was performed by Microsoft researchers Ryen White and Eric Horvitz, who conducted a large-scale study that included several phases of analysis.The New York Times covered the study. White and Horvitz defined cyberchondria as the “unfounded escalation of concerns about common symptomatology, based on the review of search results and literature on the Web.” They analyzed a representative crawl of the web for co-occurrences of symptoms with diseases in web content as well as the content returned as search results from queries on symptoms and found surprisingly high rates of linkage of rare, concerning diseases (e.g., brain tumor) to common symptoms (e.g., headache). They also analyzed anonymized large-scale logs of queries to all of the popular search engines and noted the commonality of escalations of queries from common complaints to queries on concerning diseases. They characterized the nature of escalations within a specific session and also found that potentially disruptive querying about disorders (arrived at via a search escalation) could continue in other sessions over days, weeks, and months, and that the queries could disrupt non-medical search activities. Finally, the researchers did a survey of over 500 people that confirmed the prevalence of web-induced medical anxieties and that probed several aspects of the phenomenon. The survey noted that a significant portion of subjects considered the ranking of a list of results on a medical query as somehow linked to the likelihood of relevant disorders. The researchers highlight the difference between the information provided by standard approaches to “relevance” used by search engines in ranking results and answers to medical questions, especially when searchers are looking for likelihoods of different explanations. They point out the potential importance of findings drawn from the psychology of judgment in their work. In particular, they point out that previously studied "biases of judgment" play a role in cyberchondria. The researchers highlighted the potential biases of availability (the recency and density of exposure of someone to events raises the assessed likelihood of the events) and base-rate neglect (people often do not properly consider the low prior probability of events in assessing the likelihood of events when they review evidence in support of the event) as influencing both search engines and then people searching the web. Confirmation bias, a tendency for people to confirm their preconceptions or hypotheses, may also contribute to cyberchondria.

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