Cyberchondria Rising – What is the Term’s Meaning and History?
Yesterday the AMA news informed me that cyberchondria is on the rise. So it’s a good moment to consider the term’s meaning and history.
Cyberchondria is an unfounded health concern that develops upon searching the Internet for information about symptoms or a disease. A cyberchondriac is someone who surfs the Web about a medical problem and worries about it unduly.
Through Wikipedia, I located what might be the first reference to cyberchondria in a medical journal: a 2003 article in the Journal of Neurology, Neurosurgery, and Psychiatry. A section on the new diagnosis starts like this: “Although not yet in the Oxford English Dictionary, the word ‘cyberchondria’ has been coined to describe the excessive use of internet health sites to fuel health anxiety.” That academic report links back to a 2001 story in the Independent, “Are you a Cyberchondriac?”
Two Microsoft researchers, Ryen White and Eric Horvitz, authored a “classic” paper: Cyberchondria: Studies of the Escalation of Medical Concerns in Web Search. This academic paper, published in 2009, reviews the history of cyberchondria and results of a survey on Internet searches and anxiety.
Interesting that the term – coined in a newspaper story and evaluated largely by IT experts – has entered the medical lexicon. I wonder how the American Psychiatry Association will handle cyberchondria in the upcoming DSM-5.
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Hello Dr. S. Why do I suspect that the DSM-5 may not only include this “disorder” but will also recommend a full pharmaceutical protocol for treating it? And, by the way, given that 80% of us are going online to seek out health information, why isn’t every physician distributing a “Best On the Web” list of recommended credible websites to all of their patients?
I’m of two minds on this important subject. My first concern is about misdiagnoses. We know, for example, that women heart patients are under-diagnosed (and under-treated even when appropriately diagnosed) compared to their male counterparts.
So if doctors are reading this stuff from the AMA (and other sources), will they be even more likely than they already are now to treat our complaints dismissively? I was sent home from the ER in mid-heart attack (despite textbook symptoms) by an ER doc who told me confidently: “You’re in the right demographic for GERD!” before patting me on the head and sending me away, feeling terribly embarrassed because I’d just made such a fuss “over nothing”.
On the other hand, could I have been his 10th in a row middle-aged female patient with the same complaints that day, who had all shown up in his ER, frantic because they’d been Googling their symptoms and self-diagnosing what wasn’t actually there?
On my blog, and in my frequent community presentations about women’s heart health, I meet many women who are absolutely convinced that they are in imminent danger of heart attack, often despite weeks or months of futile (and expensive) diagnostics that say otherwise. At first, I’m always alarmed that this woman’s complaints may not be taken seriously (e.g. as seriously as you and I know that a male heart patient’s complaints would be taken). But over time, I’ve come to wonder if many of these women are indeed the notorious “worried well”, sucking up medical resources and doctors’ energy, so that by the time a person like me shows up in Emerg – a real live patient in mid-heart attack! – docs are more likely to blow me off, too. There’s actually a name for this unfounded belief you’re having a heart attack: “cardiophobia”.
These people make it hard for those of us who are suffering bona fide cardiac events. It’s hard enough for women, particularly women under 55, to be assessed appropriately with legitimate heart issues, without clogging up the ER with the “worried well”.
I wrote more about this dilemma in “Catastrophizing: Why We Feel Sicker Than We Actually Are” at http://myheartsisters.org/2011/01/05/catastrophizing/
Hi Carolyn,
Thanks for your thoughts on this. You’re right; if people know about stuff that can happen, they may be more fearful of it. But if patients don’t learn and stick up for themselves, their concerns may be dismissed too readily. A hard balance –