A preliminary investigation of Cyberchondria and its correlates in a clinical sample of patients with obsessive–compulsive disorder, anxiety and depressive disorders attending a tertiary psychiatric clinic

Abstract

Objectives. This cross-sectional study aimed to investigate the frequency and presentation of cyberchondria (CYB) in patients with obsessive–compulsive disorder (OCD), anxiety disorders (ADs), and major depression disorder (MDD).

Methods. Seventy-seven patients (OCD:25, ADs:26, MDD:26) referred to a tertiary psychiatry outpatient clinic and 27 healthy controls (HCs) were included. A ‘working’ definition of CYB was used to measure CYB frequency. CYB severity was measured with the Cyberchondria Severity Scale (CSS).

Results. CYB as currently defined was present in just 1.3% of the combined patients’ sample. Using a broader definition (omitting the disability criterion), we found a higher distribution (OCD:12%, ADs:19.2%, MDD:15.4%, HCs:3.7%) and greater CYB symptom severity. Patients with OCD (63.3 ± 18.9) and ADs (63.3 ± 25.9) showed a higher CYB severity, compared with HCs (48.4 ± 9.9, p<.05). In the combined patients’ sample, a positive correlation was found between the CSS scores and measures of health anxiety or hypochondriasis. Higher CYB symptom severity emerged in patients with a positive family history of psychiatric disorders and in those prescribed benzodiazepines or mood-stabilisers.

Conclusion. CYB represents a common transdiagnostic syndrome in patients with OCD, ADs, and MDD with a spectrum of severity and indicates a variable burden of illness, supporting the need for specific clinical considerations and interventions.

Key points

• Cyberchondria (CYB) represents a common transdiagnostic syndrome in patients with obsessive–compulsive disorder, anxiety, and depressive disorders.

• CYB’s frequency as a syndrome of compulsive online health searches associated with an increased anxiety and distress was reported in 10–20% patients.

• Health anxiety/hypochondriasis showed a strong correlation with CYB.

• Patients with a positive family history of psychiatric disorders and those prescribed benzodiazepines or mood-stabilisers showed higher CYB symptom severity.

• Considering the spread of Internet use for health-related information, additional studies investigating CYB in clinical samples are encouraged.

Keywords:

• Cyberchondria
• online health information searches
• obsessive–compulsive disorder
• problematic usage of the Internet

Acknowledgements

The authors wish to acknowledge the International College of Obsessive-Compulsive Disorders (www. ICOCS.org) and the European College of Neuropsychopharmacology (ECNP) Obsessive-Compulsive and Related Disorders Research Network (OCRN), who have contributed to the development of this article through network opportunities. This article is based upon work from COST Action CA16207 ‘European Network for Problematic Usage of the Internet’, supported by COST (European Cooperation in Science and Technology) – www.cost.eu.

All authors were involved in drafting the manuscript and agreed to its publication. All authors read and approved the final version of the manuscript.

Disclosure statement

Prof. Fineberg Prof. Naomi A. Fineberg declares that in the past 3 years she has held research or networking grants from the ECNP, UK NIHR, EU H2020, MRC, University of Hertfordshire; she has accepted travel and/or hospitality expenses from the BAP, ECNP, RCPsych, CINP, International Forum of Mood and Anxiety Disorders, World Psychiatric Association, Indian Association for Biological Psychiatry, Sun; she has received payment from Taylor and Francis and Elsevier for editorial duties. In the past 3 years, she has accepted a paid speaking engagement in a webinar sponsored by Abbott. Previously, she has accepted paid speaking engagements in various industry supported symposia and has recruited patients for various industry-sponsored studies in the field of OCD treatment. She leads an NHS treatment service for OCD. She holds Board membership for various registered charities linked to OCD. She gives expert advice on psychopharmacology to the UK MHRA.

Prof. Dell'Osso has received Grant/Research Support from LivaNova, Inc., Angelini and Lundbeck and Lecture Honoraria from Angelini, FB Health and Lundbeck.

Dr Matteo Vismara, Dr Luca Ferrara, Dr Alberto Varinelli, Dr Anna Colombo, Dr Monica Bosi, Dr Luca Pellegrini, and Dr Caterina Viganò report no financial relationships with commercial interests.

Data availability statement

Data are available on request due to privacy/ethical restrictions.

Additional information

Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.