Cyberchondrie – ein neues Verhaltenssyndrom?

Eine aktive Online-Suche nach gesundheitsbezogenen Themen ist für viele Menschen nützlich, birgt allerdings auch Risiken. So kann eine extensive gesundheitsbezogene Online-Recherche oder übertriebenes digitales Self-Tracking in Verbindung mit erhöhter Krankheitsangst die Entwicklung eines Verhaltenssyndroms begünstigen, das als „Cyberchondrie“ bezeichnet wird.

Abstract

Investigation of cyberchondria is still in its infancy. Preliminary research suggests that cyberchondria is likely to represent a distinct behavioral syndrome which is closely associated with health anxiety/hypochondria and extensive online searching for health information and/or digital self-tracking. The internet is characterized by anonymous, readily, convenient space-time-independent accessibility and availability of an almost unmanageable amount of information that may increase the reassurance-seeking safety behavior of individuals with heightened health anxiety. Cyberchondria also appears to be related to low self-esteem, anxiety sensitivity, intolerance of uncertainty, compulsivity and metacognitive beliefs. At present, it is unclear of whether individuals with cyberchondria suffer from extensive health-related online searching behavior only or also from other forms of internet use disorders. The link between cyberchondria and e-health literacy, defined as perceived skills at finding, evaluating, and applying online health information to health problems, is poorly recognized. At present, there are no standardized therapeutic interventions for cyberchondria available. Treatment should address the maladaptive health- or illness-related assumptions and beliefs by using existing, well established approaches for hypochondria. Furthermore, it should target the problematic internet use and enable individuals with cyberchondria to reflect their subjective e-health literacy and promote a functional use of health resources from the internet.

Schlüsselwörter

Cyberchondrie - Krankheitsangst - Hypochondrie - Internetnutzungsstörung - digitale Gesundheitskompetenz

Key words

Cyberchondria - Health Anxiety - Hypochondriasis - Internet Use Disorder - eHealth Literacy

• Literatur

• 1 Stone J, Sharpe M. Internet resources for psychiatry and neuropsychiatry. J Neurol Neurosurg Psychiatry 2003; 74: 10-12
• 2 Eichenberg C, Wolters C, Brähler E. The internet as a mental health advisor in Germany – results of a national survey. PLoS One 2013; 8: e79206
• 3 Link E, Baumann E. Nutzung von Gesundheitsinformationen im Internet: personenbezogene und motivationale Einflussfaktoren [Use of health information on the internet: Personal and motivational influencing factors]. Bundesgesundheitsblatt-Gesundheitsforschung-Gesundheitsschutz 2020; 681-689
• 4 Marstedt G. Das Internet: Auch Ihr Ratgeber für Gesundheitsfragen. Bevölkerungsumfrage zur Suche von Gesundheitsinformationen im Internet und zur Reaktion der Ärzte. Gütersloh: Bertelsmann Stiftung; 2018;
• 5 Hurrelmann K, Klinger J, Schaeffer D. Gesundheitskompetenz der Bevölkerung in Deutschland: Vergleich der Erhebungen 2014 und 2020. Bielefeld: Universität Bielefeld, Interdisziplinäres Zentrum für Gesundheitskompetenzforschung. 2020 https://pub.uni-bielefeld.de/record/2950303 (Zugriff am 17.03.2021)
• 6 Baumann E, Czerwinski F, Rosset M. et al. Wie informieren sich die Menschen in Deutschland zum Thema Gesundheit? Erkenntnisse aus der ersten Welle von HINTS Germany. Bundesgesundheitsblatt-Gesundheitsforschung-Gesundheitsschutz 2020; 63: 1151-1160
• 7 Wangler J, Jansky M. Internetassoziierte Gesundheitsängste in der hausärztlichen Versorgung – Ergebnisse einer Befragung unter Allgemeinmedizinern und hausärztlich tätigen Internisten in Hessen. DMW-Deutsche Medizinische Wochenschrift 2019; 144: e102-e108
• 8 McMullan M. Patients using the Internet to obtain health information: How this affects the patient-health professional relationship. Patient Educ Couns 2006; 63: 24-28
• 9 White RW, Horvitz E. Cyberchondria: Studies of the escalation of medical concerns in web search. ACM Transactions on Information Systems (TOIS) 2009; 27: 1-37
• 10 Doherty-Torstrick ER, Walton KE, Fallon BA. Cyberchondria: Parsing health anxiety from online behavior. Psychosomatics 2016; 57: 390-400
• 11 Holone H. The filter bubble and its effect on online personal health information. Croat Med J 2016; 57: 298-301
• 12 Vismara M, Caricasole V, Starcevic V. et al. Is cyberchondria a new transdiagnostic digital compulsive syndrome? A systematic review of the evidence. Compr Psychiatry 2020; 99: 152167
• 13 Starcevic V, Berle D, Arnáez S. Recent insights into cyberchondria. Current Psychiatry Reports 2020; 22: 1-8
• 14 Eichenberg C, Schott M. Use of web-based health services in individuals with and without symptoms of hypochondria: Survey study. J Med Internet Res 2019; 21: e10980
• 15 Starcevic V, Baggio S, Berle D. et al. Cyberchondria and its relationships with related constructs: A network analysis. Psychiatr Q 2019; 90: 491-505
• 16 McMullan RD, Berle D, Arnáez S. et al. The relationships between health anxiety, online health information seeking, and cyberchondria: Systematic review and meta-analysis. J Affect Disord 2019; 245: 270-278
• 17 McElroy E, Shevlin M. The development and initial validation of the cyberchondria severity scale (CSS). J Anxiety Disord 2014; 28: 259-265
• 18 Loos A. Cyberchondria: Too much information for the health anxious patient?. Journal of Consumer Health on the Internet 2013; 17: 439-445
• 19 Barke A, Bleichhardt G, Rief W. et al. The Cyberchondria Severity Scale (CSS): German validation and development of a short form. Int J Behav Med 2016; 23: 595-605
• 20 Barke A, Doering BK. Development of an instrument to assess parentsʼ excessive web-based searches for information pertaining to their childrenʼs health: The “Childrenʼs Health Internet Research, Parental Inventory” (CHIRPI). J Med Internet Res 2020; 22: e16148
• 21 Starcevic V, Berle D. Cyberchondria: Towards a better understanding of excessive health-related Internet use. Expert Rev Neurother 2013; 13: 205-213
• 22 Fergus TA, Spada MM. Moving toward a metacognitive conceptualization of cyberchondria: Examining the contribution of metacognitive beliefs, beliefs about rituals, and stop signals. J Anxiety Disord 2018; 60: 11-19
• 23 Creed F, Barsky A. A systematic review of the epidemiology of somatisation disorder and hypochondriasis. J Psychosom Res 2004; 56: 391-408
• 24 Bleichhardt G, Weck F. Kognitive Verhaltenstherapie bei Hypochondrie und Krankheitsangst. Springer; 2007
• 25 Bleichhardt G, Martin A. Hypochondrie und Krankheitsangst. Göttingen: Hogrefe; 2010
• 26 Te Poel F, Baumgartner SE, Hartmann T. et al. The curious case of cyberchondria: A longitudinal study on the reciprocal relationship between health anxiety and online health information seeking. J Anxiety Disord 2016; 43: 32-40
• 27 Brand M, Wegmann E, Stark R. et al. The Interaction of Person-Affect-Cognition-Execution (I-PACE) model for addictive behaviors: Update, generalization to addictive behaviors beyond internet-use disorders, and specification of the process character of addictive behaviors. Neurosci Biobehav Rev 2019; 104: 1-10
• 28 Baumann E, Link E. Onlinebasierte Gesundheitskommunikation: Nutzung und Austausch von Gesundheitsinformationen über das Internet. In: Fischer F, Krämer A, Hrsg. eHealth in Deutschland. Berlin, Heidelberg: Springer; 2016: 385–406
• 29 Solem S, Myers SG, Fisher PL. et al. An empirical test of the metacognitive model of obsessive-compulsive symptoms: Replication and extension. J Anxiety Disord 2010; 24: 79-86
• 30 Sim NZ, Kitteringham L, Spitz L. et al. Information on the World Wide Web – how useful is it for parents?. J Pediatr Surg 2007; 42: 305-312
• 31 Cutrona SL, Mazor KM, Vieux SN. et al. Health information-seeking on behalf of others: Characteristics of “surrogate seekers”. J Cancer Educ 2015; 30: 12-19
• 32 McElroy E, Kearney M, Touhey J. et al. The CSS-12: Development and validation of a short-form version of the Cyberchondria Severity Scale. Cyberpsychol Behav Soc Netw 2019; 22: 330-335
• 33 Bleichhardt G, Hiller W. Hypochondriasis and health anxiety in the German population. Br J Health Psychol 2007; 12: 511-523
• 34 American Psychiatric Association. Diagnostic and Statistical Manual of mental disorders. 5th ed. Washington, DC: American Psychiatric Press; 2013
• 35 Stevens MWR, Dorstyn D, Delfabbro PH. et al. Global prevalence of gaming disorder: A systematic review and meta-analysis. Australian & New Zealand Journal of Psychiatry 2020; 4867420962851
• 36 Fergus TA, Spada MM. Cyberchondria: Examining relations with problematic Internet use and metacognitive beliefs. Clin Psychol Psychother 2017; 24: 1322-1330
• 37 Fergus TA, Dolan SL. Problematic internet use and internet searches for medical information: The role of health anxiety. Cyberpsychol Behav Soc Netw 2014; 17: 761-765
• 38 Fergus TA. Cyberchondria and intolerance of uncertainty: Examining when individuals experience health anxiety in response to Internet searches for medical information. Cyberpsychol Behav Soc Netw 2013; 16: 735-739
• 39 Khazaal Y, Chatton A, Rochat L. et al. Compulsive health-related internet use and cyberchondria. Eur Addict Res 2021; 27: 58-66
• 40 Meerkerk GJ, Van Den Eijnden RJ, Vermulst AA. et al. The Compulsive Internet Use Scale (CIUS): Some psychometric properties. Cyberpsychol Behav 2009; 12: 1-6
• 41 Peukert P, Steffen S, ElKasmi J. et al. Faktorielle Struktur der deutschen Version der Compulsive Internet Use Scale (CIUS) nach konfirmatorischer Faktorenanalyse. Z Klin Psychol Psychother 2012; 41: 101-108
• 42 Bajcar B, Babiak J. Self-esteem and cyberchondria: The mediation effects of health anxiety and obsessive – compulsive symptoms in a community sample. Curr Psychol 2019; 1-12
• 43 Reiss S, Peterson RA, Gursky DM. et al. Anxiety sensitivity, anxiety frequency and the prediction of fearfulness. Behav Res Ther 1986; 24: 1-8
• 44 Dugas MJ, Buhr K, Ladouceur R. The role of intolerance of uncertainty in etiology and maintenance. In: Heimberg RG, Turk CL, Mennin DS, Hrsg. Generalized anxiety disorder: Advances in research and practice. New York: The Guilford Press; 2004: 143–163
• 45 Gibler RC, Jastrowski Mano KE, OʼBryan EM. et al. The role of pain catastrophizing in cyberchondria among emerging adults. Psychol Health Med 2019; 24: 1267-1276
• 46 Sørensen K, Van den Broucke S, Fullam J. et al. Health literacy and public health: A systematic review and integration of definitions and models. BMC Public Health 2012; 12: 80
• 47 Soellner R, Huber S, Reder M. The concept of eHealth literacy and its measurement: German translation of the eHEALS. J Media Psychol 2014; 26: 29
• 48 Starcevic V. Cyberchondria: Challenges of problematic online searches for health-related information. Psychother Psychosom 2017; 86: 129-133
• 49 Newby JM, McElroy E. The impact of internet-delivered cognitive behavioural therapy for health anxiety on cyberchondria. J Anxiety Disord 2020; 69: 102150
• 50 Menon V, Kar SK, Tripathi A. et al. Cyberchondria: Conceptual relation with health anxiety, assessment, management and prevention. Asian J Psychiatr 2020; 53: 102225
• 51 Schaeffer D, Hurrelmann K, Bauer U. et al. Der Nationale Aktionsplan Gesundheitskompetenz – Notwendigkeit, Ziel und Inhalt [National action plan health literacy: Need, objective and content]. Gesundheitswesen 2018; 81: 465-470
• 52 Bundesministerium der Justiz und für Verbraucherschutz. Sozialgesetzbuch (SGB) Fünftes Buch (V) – Gesetzliche Krankenversicherung 2021 https://www.gesetze-im-internet.de/sgb_5/ (Zugriff am 17.03.2021)
• 53 Gabriels K, Moerenhout T. Exploring entertainment medicine and professionalization of self-care: Interview study among doctors on the potential effects of digital self-tracking. J Med Internet Res 2018; 20: e10
• 54 Mata J, Baumann E. The dose makes the poison: Theoretical considerations and challenges of health-related POPC. In: Vorderer P, Hefner D, Reinecke L et al (eds). Permanently online, permanently connected: Living and communicating in a POPC world. London: Routledge Taylor & Francis Group; 2017: 254–263