What is Cyberchondria? The DSM-V did away with the term “hypochondriasis” and defined two new disorders: somatic symptom disorder and illness anxiety disorder. Somatic symptom disorder occurs when patients are excessively preoccupied or fearful about one or more chronic somatic symptoms. Their fixation causes significant stress and disruption in their daily lives, and although they seek medical care often, they view their care as inadequate. Alternatively, people with illness anxiety disorder devote a great deal of time to their health concerns because they fear undiagnosed illness. They may research illnesses often and feel anxious about their own health, even though they have mild or nonexistent symptoms. The term “cyberchondria,” coined by the Mayo Clinic and others, describes somatic symptom disorder and illness anxiety disorder patients that use the Web to convert excessive research into self-diagnosis. The Dangers of Cyberchondria Cyberchondriac patients don’t always come to doctors to report a set of symptoms. In some cases, they come to a doctor and claim that they’ve been previously diagnosed with a disorder that they’ve only read about online. The greatest danger occurs when a cyberchondriac patient demands unnecessary diagnostic tests or even unnecessary treatments. Doctors may capitulate either because they’ve been misled or because they’re unwilling to refuse. Patients that have unnecessary and invasive medical workups and treatments place themselves at risk for medically induced illness. It’s the ultimate self-fulfilling prophecy: they create the circumstances they fear most. Thanks to the Web, everyone has become an expert. Unfortunately, most patients have no medical training, so they lack the expertise to apply medical content correctly or to judge the quality of the content’s source. Accurate, appropriately applied information empowers patients, but misinformation makes patients feel empowered when in reality, they’re just misguided. They question the expertise of their doctors and nurses under the false assumption that they know something that a health professional doesn’t. What Doctors and Nurses Can Do Doctors and nurses can take the following steps to prevent harm to cyberchondriacs: Vet new patients. If approached by a new patient, make sure to completely review the patient’s medical history, including available records, before ordering procedures or treatments. Give the patient time. It’s easy to become annoyed with a cyberchondriac patient who makes repeated office visits and doesn’t seem to listen to reason. However, dismissing or ignoring the patient isn’t the right way to address the problem. Take a team approach. Talk over the patient’s case with colleagues, or refer the patient for a second opinion. Collaborate with a patient’s current psychologist or psychiatrist, or recommend adding one to the patient’s medical team. Try to keep the patient with someone known and trusted for as long as possible. Weigh the options. When they can’t find answers for a cyberchondriac patient, many doctors and nurses feel afraid to say, “It might be all in your head.” They want to give patients dignity, and they fear potential harm and litigation. It’s crucial to weigh the potential harm of doing nothing against the potential harm that medically induced illness could cause. Florence Nightingale might have genuinely believed she was ill. She also might have used the excuse of illness to avoid stereotypically Victorian female activities, like social engagements and domestic work. Whatever her motives, Ms. Nightingale managed to accomplish a lot from her sickroom, but things don’t always turn out so well for others with imagined ailments. Unfortunately, thanks to the Web, imaginations are getting bigger every day. Source
