Menon Vikas, Kar Sujita Kumar, Tripathi Adarsh, Nebhinani Naresh, Varadharajan Natarajan
Dept of Psychiatry, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, 605006, India.
Dept of Psychiatry, King George's Medical University, Lucknow, Uttar Pradesh, 226003, India.
Asian J Psychiatr. 2020 Oct;53:102225. doi: 10.1016/j.ajp.2020.102225. Epub 2020 Jun 15.
There is a need to synthesize available information on the emerging construct of cyberchondria to guide evidence informed practice. With this in mind, electronic search of databases including MEDLINE via PubMed, Cochrane Library, ScienceDirect and Google scholar were carried out from inception till March 2020 to identify relevant English language peer reviewed articles related to cyberchondria. Generated abstracts were grouped according to their thematic focus and summarized. A total of 49 articles were reviewed. Articles directly evaluating cyberchondria were very few and most of the treatment evidence was extrapolated from trials on health anxiety. Cyberchondria appears to be a phenomenologically overlapping entity with, yet distinguishable from, health anxiety and there may be merit in studying the two constructs separately. Four validated self-assessment measures for cyberchondria are available in literature. Cognitive behaviour therapy (CBT) delivered either physically or through the internet (iCBT) have been found to be effective for both health anxiety and cyberchondria. Pharmacologic strategies for health anxiety have mainly involved the use of Selective Serotonin Reuptake Inhibitors, with mean effective dosages higher than for depression/anxiety. Prevention of cyberchondria needs to focus on appropriate harm reduction strategies as well as supply and demand side measures. Internet based CBT therapies hold promise for management of cyberchondria. This finding must be considered preliminary due to limited evidence. Further study is required to establish the diagnostic validity of cyberchondria.
有必要综合关于网络疑病症这一新兴概念的现有信息，以指导循证实践。考虑到这一点，从数据库建立之初到2020年3月，我们通过PubMed对MEDLINE、Cochrane图书馆、ScienceDirect和谷歌学术等数据库进行了电子检索，以识别与网络疑病症相关的英文同行评审文章。生成的摘要根据其主题重点进行分组并总结。总共审查了49篇文章。直接评估网络疑病症的文章很少，大多数治疗证据是从健康焦虑症试验中推断出来的。网络疑病症似乎在现象学上与健康焦虑症重叠，但又与之不同，分别研究这两个概念可能有价值。文献中有四种经过验证的网络疑病症自我评估方法。已发现物理方式或通过互联网提供的认知行为疗法（iCBT）对健康焦虑症和网络疑病症均有效。治疗健康焦虑症的药物策略主要涉及使用选择性5-羟色胺再摄取抑制剂，其平均有效剂量高于治疗抑郁症/焦虑症的剂量。预防网络疑病症需要关注适当的减少伤害策略以及供需双方的措施。基于互联网的CBT疗法有望用于网络疑病症的管理。由于证据有限，这一发现必须被视为初步的。需要进一步研究以确定网络疑病症的诊断效度。
