Bessière Katie, Pressman Sarah, Kiesler Sara, Kraut Robert
Human-Computer Interaction Institute, Carnegie Mellon University, Pittsburgh, PA 15213, USA.
J Med Internet Res. 2010 Feb 28;12(1):e6. doi: 10.2196/jmir.1149.
The rapid expansion of the Internet has increased the ease with which the public can obtain medical information. Most research on the utility of the Internet for health purposes has evaluated the quality of the information itself or examined its impact on clinical populations. Little is known about the consequences of its use by the general population.
Is use of the Internet by the general population for health purposes associated with a subsequent change in psychological well-being and health? Are the effects different for healthy versus ill individuals? Does the impact of using the Internet for health purposes differ from the impact of other types of Internet use?
Data come from a national US panel survey of 740 individuals conducted from 2000 to 2002. Across three surveys, respondents described their use of the Internet for different purposes, indicated whether they had any of 13 serious illnesses (or were taking care of someone with a serious illness), and reported their depression. In the initial and final surveys they also reported on their physical health. Lagged dependent variable regression analysis was used to predict changes in depression and general health reported on a later survey from frequency of different types of Internet use at an earlier period, holding constant prior depression and general health, respectively. Statistical interactions tested whether uses of the Internet predicted depression and general health differently for people who initially differed on their general health, chronic illness, and caregiver status.
Health-related Internet use was associated with small but reliable increases in depression (ie, increasing use of the Internet for health purposes from 3 to 5 days per week to once a day was associated with .11 standard deviations more symptoms of depression, P = .002). In contrast, using the Internet for communication with friends and family was associated with small but reliable decreases in depression (ie, increasing use of the Internet for communication with friends and family purposes from 3 to 5 days per week to once a day was associated with .07 standard deviations fewer symptoms of depression, P = .007). There were no significant effects of respondents' initial health status (P = .234) or role as a caregiver (P = .911) on the association between health-related Internet use and depression. Neither type of use was associated with changes in general health (P = .705 for social uses and P = .494 for health uses).
Using the Internet for health purposes was associated with increased depression. The increase may be due to increased rumination, unnecessary alarm, or over-attention to health problems. Additionally, those with unmeasured problems or those more prone to health anxiety may self-select online health resources. In contrast, using the Internet to communicate with friends and family was associated with declines in depression. This finding is comparable to other studies showing that social support is beneficial for well-being and lends support to the idea that the Internet is a way to strengthen and maintain social ties.
互联网的迅速扩张使得公众获取医学信息变得更加容易。大多数关于互联网在健康方面用途的研究都评估了信息本身的质量，或者研究了其对临床人群的影响。对于普通人群使用互联网的后果，我们知之甚少。
普通人群出于健康目的使用互联网是否与随后的心理健康和健康状况变化相关？健康个体与患病个体的影响是否不同？出于健康目的使用互联网的影响与其他类型的互联网使用的影响是否不同？
数据来自2000年至2002年对740名美国人进行的一项全国性面板调查。在三次调查中，受访者描述了他们出于不同目的使用互联网的情况，表明他们是否患有13种严重疾病中的任何一种（或者是否在照顾患有严重疾病的人），并报告了他们的抑郁情况。在最初和最终的调查中，他们还报告了自己的身体健康状况。使用滞后因变量回归分析，分别在保持先前抑郁和总体健康状况不变的情况下，根据早期不同类型互联网使用的频率来预测后期调查中报告的抑郁和总体健康状况的变化。统计交互作用检验了对于在总体健康、慢性病和照顾者身份方面最初存在差异的人群，互联网使用是否对抑郁和总体健康有不同的预测作用。
与健康相关的互联网使用与抑郁的小幅但可靠的增加相关（即，将出于健康目的使用互联网的频率从每周3天增加到5天再到每天一次，与抑郁症状增加0.11个标准差相关，P = 0.002）。相比之下，使用互联网与朋友和家人交流与抑郁的小幅但可靠的减少相关（即，将出于与朋友和家人交流目的使用互联网的频率从每周3天增加到5天再到每天一次，与抑郁症状减少0.07个标准差相关，P = 0.007）。受访者的初始健康状况（P = 0.234）或作为照顾者的角色（P = 0.911）对与健康相关的互联网使用和抑郁之间的关联没有显著影响。两种使用类型均与总体健康状况的变化无关（社交用途P = 0.705，健康用途P = 0.494）。
出于健康目的使用互联网与抑郁增加相关。这种增加可能是由于沉思增加、不必要的恐慌或对健康问题的过度关注。此外，那些有未被测量问题的人或更容易出现健康焦虑的人可能会自行选择在线健康资源。相比之下，使用互联网与朋友和家人交流与抑郁下降相关。这一发现与其他表明社会支持对幸福感有益的研究结果相当，并支持了互联网是加强和维持社会联系的一种方式的观点。
