Xu Richard Huan, Liang Xiao, Starcevic Vladan
Department of Rehabilitation Sciences, Faculty of Health and Social Sciences, Hong Kong Polytechnic University, Hong Kong, China (Hong Kong).
Faculty of Medicine and Health, Specialty of Psychiatry, Nepean Clinical School, Sydney Medical School, University of Sydney, Sydney, Australia.
J Med Internet Res. 2025 Apr 2;27:e72414. doi: 10.2196/72414.
The proliferation of internet-based health information has intensified cyberchondria, or anxiety resulting from excessive health-related searches. The relationship between cyberchondria and suicidal ideation remains underexplored, although there are indications that people with high levels of cyberchondria may also be suicidal. Understanding this relationship is critical, given rising digital health-seeking behaviors and the need to mitigate suicide risk. Emerging evidence suggests that psychological distress can mediate the relationship between cyberchondria and suicidal ideation. However, to the best of our knowledge, no research has directly examined these associations.
This study had two aims. The first was to examine the relationship between cyberchondria and suicidal ideation in a sample of the general Chinese population. The second aim was to investigate the possible role of psychological distress, reflecting the symptoms of depression and anxiety, as a mediator in the relationship between cyberchondria and suicidal ideation.
Data were obtained from a cross-sectional and web-based survey conducted in 2024. Structural equation modeling analysis was used to assess the hypothesized association between cyberchondria and suicidal ideation, as well as the mediating effect of psychological distress on this association. The Cyberchondria Severity Scale-12 items, Suicidal Ideation Attributes Scale, and Kessler Psychological Distress Scale-10 items were used to measure cyberchondria, suicidal ideation, and psychological distress, respectively. Standardized (β) estimates, along with their 95% CIs, were calculated for all structural paths, adjusting for participants' background characteristics.
A total of 2415 individuals completed the questionnaire (response rate=98.5%). Scores on the Cyberchondria Severity Scale-12 items ranged from 12 to 60, with the mean score being 40 (SD 7.9). The mean score on the Suicidal Ideation Attributes Scale was 12.7 (SD 9.9). Scores on the Kessler Psychological Distress Scale-10 items ranged from 10 to 50, and the mean score was 22 (SD 6.9). Cyberchondria, suicidal ideation, and psychological distress were significantly correlated. Structural equation modeling revealed a significant association between cyberchondria and psychological distress (β=.281; P<.001), between psychological distress and suicidal ideation (β=.504; P<.001), and between cyberchondria and suicidal ideation (β=.107; P<.001). The indirect effect of cyberchondria on suicidal ideation through psychological distress was also significant (β=.142; P<.001).
The main contribution of this study is that it highlights an important relationship between cyberchondria and suicidal ideation, with a direct and statistically significant association between these variables. Their relationship is also mediated by psychological distress, which reflects the role of depressive and anxiety symptoms.
基于互联网的健康信息激增加剧了网络疑病症，即因过度进行与健康相关的搜索而产生的焦虑。尽管有迹象表明网络疑病症程度高的人可能也有自杀倾向，但网络疑病症与自杀意念之间的关系仍未得到充分研究。鉴于寻求数字健康行为的增加以及降低自杀风险的必要性，了解这种关系至关重要。新出现的证据表明，心理困扰可能在网络疑病症与自杀意念之间的关系中起中介作用。然而，据我们所知，尚无研究直接考察这些关联。
本研究有两个目的。第一个目的是在一般中国人群样本中考察网络疑病症与自杀意念之间的关系。第二个目的是调查反映抑郁和焦虑症状的心理困扰作为网络疑病症与自杀意念之间关系的中介的可能作用。
数据来自于2024年进行的一项横断面网络调查。采用结构方程模型分析来评估网络疑病症与自杀意念之间的假设关联，以及心理困扰对该关联的中介作用。分别使用网络疑病症严重程度量表（12项）、自杀意念属性量表和凯斯勒心理困扰量表（10项）来测量网络疑病症、自杀意念和心理困扰。计算所有结构路径的标准化（β）估计值及其95%置信区间，并对参与者的背景特征进行调整。
共有2415人完成了问卷（应答率 = 98.5%）。网络疑病症严重程度量表（12项）的得分范围为12至60分，平均分为40分（标准差7.9）。自杀意念属性量表的平均分为12.7分（标准差9.9）。凯斯勒心理困扰量表（10项）的得分范围为10至50分，平均分为22分（标准差6.9）。网络疑病症、自杀意念和心理困扰之间存在显著相关性。结构方程模型显示，网络疑病症与心理困扰之间存在显著关联（β = 0.281；P < 0.001），心理困扰与自杀意念之间存在显著关联（β = 0.504；P < 0.001），网络疑病症与自杀意念之间存在显著关联（β = 0.107；P < 0.001）。网络疑病症通过心理困扰对自杀意念的间接效应也显著（β = 0.142；P < 0.001）。
本研究的主要贡献在于突出了网络疑病症与自杀意念之间的重要关系，这些变量之间存在直接且具有统计学意义的关联。它们之间 的关系也由心理困扰介导，这反映了抑郁和焦虑症状的作用。
