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Online health info can make you crazy
By DEIRDRE FULTON  |  July 22, 2009


Last year, a co-worker (who shall remain nameless to save her from additional embarrassment) discovered a bug bite on her leg. It was slightly different than a typical mosquito bite; it was more bruise-like, and a bit painful to the touch. Not having any insect-bite specialists on hand, my colleague turned to the Internet for help identifying the source of her ailment.

A few Google searches, some gruesome image results, and one active imagination later, said colleague had convinced herself that hers was no harmless bug bite, that it was probably a spider bite, and that it just might be a brown recluse spider bite (these turn necrotic, which means the tissue around the wound dies and disintegrates, and can be fatal). Or, as she recalls: "I was concerned that I had a viciously poisonous spider bite...I don't remember what exactly I Googled, but after all was said and done I was convinced I either had Lyme Disease, I was anemic, or that a bot fly was going to hatch from beneath my skin."

In other words, much fretting ensued. She made an appointment with her doctor, and dragged me along for moral support. In the physician's office, the hysteria began to wear off a bit. The doctor said there was nothing to worry about — that it was just a nontoxic, if aggravated, bug bite that would clear up in a day or two. Which, of course, it did.

For a few hours, my co-worker became a cyberchondriac — part of a new generation of health-information consumers whose use of the Internet can create or exacerbate unfounded health concerns. It's a version of hypochondria, a mental-health condition that's been studied for centuries, which involves a distracting preoccupation with one's personal health status, as well as a tendency to imagine the worst based on even the most common or benign symptoms.

Cyberchondria — a term coined around 2002 — isn't an official diagnosis (though hypochondriasis is included in the Diagnostic and Statistical Manual of Mental Disorders, the official medical handbook of mental-health disorders), but the phenomenon is increasingly acknowledged by the media, and medical professionals. It was dubbed a 2008 Word of the Year by Webster's New World reference books. Among 20- and 30-something Web-users who utilize the Internet in every aspect of their lives — and who, incidentally, comprise a large chunk of the nation's under- and uninsured who rarely see flesh-and-blood health professionals — cyberchondria is common.

See, the Internet makes it easy for anyone to join the ranks of Howard Hughes, Tennessee Williams, and my mother — famous hypochondriacs known for their unswerving commitment to imagined worst-case scenarios. Whereas hypochondria used to be reserved for inventive neurotics and medical students ("med school hypochondria" is a widely acknowledged condition, and not a surprising one, given the amount of terrifying information that future doctors absorb), the nature of the Internet lends itself to scaring the general public. Studies show that 80 percent of American adults use the Internet to find health care information. Non-discriminatory search results, which don't take into account how common a disease is or how susceptible the individual is to it, can lead the symptom-searcher to make dramatic, (il)logical leaps.

Combine sensational search results with an anxious populace — not to mention a few stories (some urban legends, some apparently true) about people who actually do figure out their own health mysteries online after their symptoms stump doctors — and you have fertile ground for cyberchondria. Thus, a headache becomes a brain tumor (rather than, say, caffeine withdrawal), muscle twitches are almost certainly multiple sclerosis (not fatigue, which is much more likely); and absolutely everything is cancer.

Solid sources:Where to go to avoid cyberchondria
Based on their affiliations, information sources, motives, advertisers, design, accuracy, and tone, Consumer Reports WebWatch ranked several health Web sites in 2002. The top four sites were:

1) The National Institutes of Health
4) (associated with Harvard Medical School)

The most important factors in deciding these rankings were transparency of sources (authors and credentials are listed for most, if not all, articles on these sites), and the extent of possible commercial interests/biases. Sites that fared worse in the Consumer Reports study (such as Health Bulletin, HealthWorld, or Oxygen Health) did so because of their commercial focus ("too many ads" was a prominent complaint) or lack of academic rigor and original content.

Rule of Thumb: If you're perusing a health Web site and feel like you're getting a sales pitch, it's time to look elsewhere.

Misusing, and misinterpreting, online medical information "can lead users to believe that common symptoms are likely the result of serious illnesses," Microsoft researchers Eric Horvitz and Ryen White wrote in their 2008 study, "Cyberchondria: Studies of the Escalation of Medical Concerns in Web Search," published through Microsoft's research and development arm. The study was the first to attempt to quantitatively analyze cyberchondriac tendencies. "Such escalations ... may lead to unnecessary anxiety, investment of time, and expensive engagements with healthcare professionals," they wrote.

The Microsoft study found, among other things, that Web searches of common symptoms are just as likely (and in some cases more likely) to turn up serious explanations as non-threatening ones. For example, if someone enters "bug bite" into a search engine, she might see just as many results referencing poisonous spiders as those dealing with infected mosquito bites — despite the fact that the latter justification is exponentially more probable. Some people, the scientists say, equate prevalence in search results with diagnostic likelihood — the closer to top of the pile, the more realistic it seems as a medical explanation. Obviously, that's bunk. But the Microsoft study found that rank order of search results made one in 10 subjects more anxious.

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