The Relationship between Cyberchondria and Health Anxiety and the Moderating Role of Health Literacy among the Pakistani Public.

Following the COVID-19 pandemic, the current study examines the association between cyberchondria and health anxiety in the Pakistani population, with health literacy as a moderator. This study utilized a cross-sectional research approach, with data gathered through simple random sampling. The study enlisted 1295 participants from Pakistan aged between 18 and 70, 63% of whom were male and 36% of whom were female. The researchers found a statistically significant positive link between cyberchondria and health anxiety (ß = 0.215; t = 1.052; p 0.000). The moderating influence of health literacy suggests that health anxiety has a significantly negative effect on the relationship between cyberchondria and health anxiety (ß = -0.769; t = 2.097; p 0.037). Moreover, females had higher cyberchondria scores than males. Health-related anxiety did not differ between the sexes, and males had greater health literacy than females. These results emphasize the critical role of health literacy in the moderating effects of cyberchondria on health anxiety. Furthermore, they reveal significant gender differences in both cyberchondria and health literacy.

Cyberchondria, Health Literacy, and Perception of Risk in Croatian Patients with Risk of Sexually Transmitted Infections and HIV-A Cross-Sectional Study.

Background: The perception of the risk of sexually transmitted infections (STIs) is a well-researched phenomenon, but not in relation to cyberchondria and health literacy. Therefore, our aim was to examine the association between the assessment of the risk of sexually transmitted diseases and HIV, cyberchondria, and health literacy. Materials and methods: This study was conducted in 2020-2021 in Croatia. The experimental group consisted of patients from the Centre for Voluntary Counselling and Testing for HIV (N = 134). The control group consisted of other patients recruited from daily epidemiological practices (N = 171). The instruments that were used were questionnaires that measure the perception of risk of sexually transmitted infections and HIV, health literacy, and cyberchondria. Results: Out of 305 respondents, 134 (43.9%) were in the STI counselling group, and 171 (56.1%) were in the control group. Generally, the participants in the former perceived the risk of sexually transmitted infections and HIV to be higher (but still low) than those in the latter. There was no difference in health literacy between the STI and control group; the health literacy score was average in both groups. There were differences in almost all the cyberchondria factors, except for Mistrust. Health literacy, belonging to the STI counselling group, and risk behaviours were positively associated with CH in the logistic regression analysis. Conclusions: People with a risk for STIs tend to minimize this risk, have higher cyberchondria levels, and have average health literacy. Cyberchondria is positively associated with health literacy, and more education about excessive health-related internet research is needed.

The digital health dilemma: Exploring cyberchondria, well-being, and smartphone addiction in medical and non-medical undergraduates.

Background: The Internet is a popular source of health information, but too much research can cause anxiety (cyberchondria). Medical and non-medical personnel interpret information differently, leading to varying rates of cyberchondria. Smartphone addiction may also contribute to cyberchondria and impact mental health. Methods: The study was an epidemiological survey-based investigation with a cross-sectional design involving undergraduate students (aged 18 years or older) from Indian universities or colleges. The study utilized the Cyberchondria Severity Scale-Short Form (CSS-12), WHO-5 well-being index, and Smartphone Addiction Scale-Short Version (SAS-SV). Results: A total of 1033 participants (53.1% females and 46.4% males) were recruited in the survey. Of the participants, 58.5% were pursuing medical or paramedical courses, while the remaining 41.5% belonged to the non-medical group. High-severity cyberchondria was present in about 4.4% of the students. The medical cohort demonstrated a significantly lower cumulative CSS in comparison to the non-medical cohort (t = - 3.90; P < 0.01). Smartphone addiction was observed in 57.2% of individuals in the medical group and 55.9% of individuals in the non-medical group (P = 0.68). Medical students had a significantly lower mean well-being score compared to non-medical students (58.4 vs. 59.6; P < 0.01). There was a positive correlation between cyberchondria severity and smartphone addiction, which was consistent across both groups. Conclusion: Medical students have less cyberchondria than non-medical students. Cyberchondria severity is linked to smartphone addiction. Non-medical students with cyberchondria have higher subjective well-being.

Googling and health anxiety in older age-A case study of CBT incorporating a single case experimental design.

The use of online search engines to "google" health-related information is common in health anxiety, and requires careful consideration within psychological treatment. Its nature in older adult populations is less closely understood. This report demonstrates the reduction in googling frequency using cognitive-behavioral therapy in an 83-year-old female with health anxiety.

Cyberchondria levels in adolescent patients with polycystic ovary syndrome in the digital age.

STUDY OBJECTIVE: Cyberchondria is defined as a form of anxiety characterized by excessive health searches on the Internet. Our aim in this study is to investigate the extent of cyberchondria in adolescents with polycystic ovary syndrome and to compare them with adolescents of the same age. METHODS: 426 adolescents who presented to clinic between April 2023 and September 2023 and agreed to participate in the study were included in the study. Patients were divided into two groups: polycystic ovary syndrome (PCOS) group (135 patients) and control group (291 patients). The Cyberchondria Severity Scale (CSS) was administered to participants face-to-face. The CSS and subscale scores of both patient groups were analyzed and compared. RESULTS: Total CSS scores were significantly different between groups (p=.007) with a mean value of 72 (59-83) in the control group and 77 (63-91) in the PCOS group. When cyberchondria subscales were analysed, statistical difference was found between the groups in the subcategories of compulsion (p:0.015), distress (p:0.039), excessiveness (p:0.028) and mistrust of medical professional (p:0.005). CONCLUSIONS: Adolescents with PCOS demonstrated higher levels of cyberchondria which could aggravate associated symptoms of anxiety and depression. Health providers should be mindful to evaluate internet use in this patient population and provide anticipatory guidance.

A national survey of pandemic fear and cyberchondria after ending zero-COVID policy: The chain mediating role of alexithymia and psychological distress.

BACKGROUND: More than half the domestic population in China were infected with COVID-19 in two months after ending "zero-infection policy", which severely overwhelmed frontline healthcare providers with stress and fear. However, there is no study to date investigating the associations between nurses' fear of pandemic and cyberchondria. This study aimed to 1) investigate the correlations between fear pandemic and cyberchondria among frontline nurses, and 2) discover its potential mechanism. METHODS: A cross-sectional sample of frontline nurses (N = 8161) was recruited from 98 hospitals across China in February 2023. Participants were invited to complete an online, self-rated standardized questionnaire focused on pandemic fear, alexithymia, psychological distress, and cyberchondria. Environmental, clinical and socioeconomic information were collected for adjustment while conducting chain mediation analysis. RESULTS: When other covariates were controlled, it was found that fear of the pandemic significantly contributed to cyberchondria (b = 0.58, 95%CI [0.56, 0.60], p < .001). The chain mediation model suggested that both alexithymia and psychological distress were mediating factors between pandemic fear and cyberchondria. CONCLUSIONS: The higher the perceived fear, the greater the cyberchondria, which suggests that reducing fear about the pandemic and providing adequate support could reduce the incidence of cyberchondria. As alexithymia and psychological distress may be transdiagnostic mechanisms between fear and cyberchondria, targeted interventions focused on expression dysregulation and emotional identification could be useful.

Mechanistic studies in pathological health anxiety: A systematic review and emerging conceptual framework.

BACKGROUND: Pathological health anxiety (PHA) (e.g., hypochondriasis and illness anxiety disorder) is common in medical settings and associated with increased healthcare costs. However, the psychological and neurobiological mechanisms contributing to the development and maintenance of PHA are incompletely understood. METHODS: We performed a systematic review to characterize the mechanistic understanding of PHA. PubMed, PsycINFO, and Embase databases were searched to find articles published between 1/1/1990 and 12/31/2022 employing a behavioral task and/or physiological measures in individuals with hypochondriasis, illness anxiety disorder, and PHA more broadly. RESULTS: Out of 9141 records identified, fifty-seven met inclusion criteria. Article quality varied substantially across studies, and was overall inadequate. Cognitive, behavioral, and affective findings implicated in PHA included health-related attentional and memory recall biases, a narrow health concept, threat confirming thought patterns, use of safety-seeking behaviors, and biased explicit and implicit affective processing of health-related information among other observations. There is initial evidence supporting a potential overestimation of interoceptive stimuli in those with PHA. Neuroendocrine, electrophysiology, and brain imaging research in PHA are particularly in their early stages. LIMITATIONS: Included articles evaluated PHA categorically, suggesting that sub-threshold and dimensional health anxiety considerations are not contextualized. CONCLUSIONS: Within an integrated cognitive-behavioral-affective and predictive processing formulation, we theorize that sub-optimal illness and health concepts, altered interoceptive modeling, biased illness-based predictions and attention, and aberrant prediction error learning are mechanisms relevant to PHA requiring more research. Comprehensively investigating the pathophysiology of PHA offers the potential to identify adjunctive diagnostic biomarkers and catalyze new biologically-informed treatments.

Anxiety sensitivity moderates the relationship between internet addiction and cyberchondria among nurses.

Internet addiction and cyberchondria have a bidirectional relationship. However, no known studies have evaluated the moderating role of anxiety sensitivity in that relationship. The study aimed to determine whether anxiety sensitivity moderates the relationship between internet addiction and cyberchondria among Jordanian nurses. Data were collected from 303 nurses using a web-based survey and convenience snowballing sampling methods using a cross-sectional research design. The Internet Addiction Test and the short version of the Cyberchondria Severity Scale were used to assess internet addiction and cyberchondria. Nurses reported mild internet addiction, low anxiety sensitivity, and moderate cyberchondria. Also, these findings suggested that sensitivity to anxious feelings moderates the relationship between internet addiction and cyberchondria. These findings would help nurses use psychosocial interventions for people with internet addiction and cyberchondria by understanding how their anxiety sensitivity promotes their internet addiction and cyberchondria.

The impact of online health information source preference on intolerance to uncertainty and cyberchondria in a youthful generation.

Background: The increasing utilization of the Internet to access health-related information is believed to heighten anxiety and trigger cyberchondria due to the presence of conflicting and sometimes overly detailed information. Aim: To investigate the levels of cyberchondria and intolerance of uncertainty among university students and their relationship with different online health information sources. Methods: Between June and July 2022, 420 university students (mean age = 21.5 ± 2 years, 54% female) participated in this cross-sectional study. The socio-demographic form, Uncertainty Intolerance Scale (IUS), and Cyberchondria Severity Scale (CSS) were used in data collection. Pearson correlation test and binary logistic regression analysis were used to identify factors associated with cyberchondria. Results: Forums and private hospital/clinic websites were the most frequently utilized online health information sources, while governmental websites were the least. The mean scores for CSS and IUS were 81.5 and 41.0, respectively. There was no significant gender-based difference in CSS and IUS scores. Students who used newspapers/magazines and social media for health information had significantly higher scores on both scales. Cyberchondria had a negative association with age [odds ratio (OR) = 0.90], a positive significant relationship with newspaper/magazine website use (OR = 7.24), and IUS score (OR = 1.09). There was a positive and moderate correlation between CSS and IUS scores (r = 0.39, P < 0.001). Conclusions: Our results underline the susceptibility to cyberchondria and intolerance of uncertainty among young adults who used less reliable online health information sources and highlight promoting online health literacy to reduce vulnerabilities and the need for further research on socio-demographic determinants in both mental problems.

Cyberchondria and smartphone addiction: A correlation survey among undergraduate medical students in Egypt.

BACKGROUND: There is an increase in smartphone usage globally. Cyberchondria (CYB) is characterized by excessive Internet searches for health information. Smartphone addiction is constantly rising among medical students together with CYB as a collateral emerging risk, yet there is limited research available on the topic. METHODS: This cross-sectional study explores the rising phenomenon of smartphone addiction and its potential role in CYB among medical students in seven Egyptian universities. A total of 1435 medical students participated in completing online questionnaires that assessed smartphone addiction and CYB using the Smartphone Addiction Scale-Short Version (SAS-SV) and Cyberchondria Severity Scale (CSS-12). Multivariable regression analysis was applied to assess predictors of smartphone addiction and CYB. RESULTS: Based on the used scales, 57.6% of students were suffering from smartphone addiction, and 85.8% exhibited a moderate degree of CYB. There was a significant positive correlation between smartphone addiction scores and CYB (p < 0.05). The multivariable regression models revealed that four factors including using Facebook, using WhatsApp, increasing time spent on the Internet per day, and a higher CYB score increase the probability of smartphone addiction. The factors that increase the probability of CYB are using Facebook, an increase in the frequency of Internet searches, a higher degree of worry about one's health or a family member's health, and being a smartphone addict. CONCLUSION: Smartphone addiction among undergraduate medical students is prevalent. Social media use, time spent online, and smartphone addiction were linked with the risk of CYB. Regular physical activity decreases the probability of smartphone addiction. Awareness programs and increased mental and physical activities are required to help reduce smartphone addiction among youth.

Moderating Effect of Coping Strategies on the Association Between the Infodemic-Driven Overuse of Health Care Services and Cyberchondria and Anxiety: Partial Least Squares Structural Equation Modeling Study.

BACKGROUND: The COVID-19 pandemic has led to a substantial increase in health information, which has, in turn, caused a significant rise in cyberchondria and anxiety among individuals who search for web-based medical information. To cope with this information overload and safeguard their mental well-being, individuals may adopt various strategies. However, the effectiveness of these strategies in mitigating the negative effects of information overload and promoting overall well-being remains uncertain. OBJECTIVE: This study aimed to investigate the moderating effect of coping strategies on the relationship between the infodemic-driven misuse of health care and depression and cyberchondria. The findings could add a new dimension to our understanding of the psychological impacts of the infodemic, especially in the context of a global health crisis, and the moderating effect of different coping strategies on the relationship between the overuse of health care and cyberchondria and anxiety. METHODS: The data used in this study were obtained from a cross-sectional web-based survey. A professional survey company was contracted to collect the data using its web-based panel. The survey was completed by Chinese individuals aged 18 years or older without cognitive problems. Model parameters of the relationships between infodemic-driven overuse of health care, cyberchondria, and anxiety were analyzed using bootstrapped partial least squares structural equation modeling. Additionally, the moderating effects of coping strategies on the aforementioned relationships were also examined. RESULTS: A total of 986 respondents completed the web-based survey. The mean scores of the Generalized Anxiety Disorder-7 and Cyberchondria Severity Scale-12 were 8.4 (SD 3.8) and 39.7 (SD 7.5), respectively. The mean score of problem-focused coping was higher than those of emotion- and avoidant-focused coping. There was a significantly positive relationship between a high level of infodemic and increased overuse of health care (bootstrapped mean 0.21, SD 0.03; 95% CI 0.1581-0.271). The overuse of health care resulted in more severe cyberchondria (bootstrapped mean 0.107, SD 0.032) and higher anxiety levels (bootstrapped mean 0.282, SD 0.032) in all the models. Emotion (bootstrapped mean 0.02, SD 0.008 and 0.037, SD 0.015)- and avoidant (bootstrapped mean 0.026, SD 0.009 and 0.049, SD 0.016)-focused coping strategies significantly moderated the relationship between the overuse of health care and cyberchondria and that between the overuse of health care and anxiety, respectively. Regarding the problem-based model, the moderating effect was significant for the relationship between the overuse of health care and anxiety (bootstrapped mean 0.007, SD 0.011; 95% CI 0.005-0.027). CONCLUSIONS: This study provides empirical evidence about the impact of coping strategies on the relationship between infodemic-related overuse of health care services and cyberchondria and anxiety. Future research can build on the findings of this study to further explore these relationships and develop and test interventions aimed at mitigating the negative impact of the infodemic on mental health.

The relationship between orthorexia nervosa and cyberchondria levels in nurses: A cross-sectional study.

PURPOSE: The study was conducted with the aim of investigating the relationship between orthorexia nervosa and cyberchondria levels among nurses. METHODS: This cross-sectional study was conducted with 399 nurses through face-to-face interviews. The data were collected using a participant information form, the Cyberchondria Severity Scale, and the Orthorexia Nervosa-11 scale (ORTO-11). RESULTS: The mean score of the nurses' cyberchondria severity scale was 73.95 ± 18.53, while the mean score of the Orthorexia Nervosa-11 scale was 28.23 ± 4.76. In the study, a low negative correlation was found between the cyberchondria and orthorexia nervosa levels (p < 0.05). CONCLUSIONS: The increase in the level of cyberchondria among nurses increases the risk of orthorexia nervosa. Therefore, it is recommended that nurses receive proper nutritional education and psychosocial support to reduce their tendency towards orthorexia nervosa and cyberchondria.

Cyberchondria severity and utilization of health services in Polish society: a cross-sectional study.

BACKGROUND: It has been suggested that cyberchondria leads to increased utilization of healthcare services. Unfortunately, not many studies have analyzed this effect comprehensively. The aim of this study was to analyze the relationship between cyberchondria severity and the utilization of healthcare services among adult Internet users after adjusting for sociodemographic characteristics and the health status of respondents. METHODS: The analysis detailed in this paper examined data from a computer-based, web-based interviewing survey performed among a representative sample of 1613 Polish Internet users. Cyberchondria severity was assessed with the Cyberchondria Severity Scale (CSS). The variables reflecting the use of healthcare services were based on the frequency of visits to family physicians and specialists, diagnostic procedures, hospital admissions, and emergency services, and finally being vaccinated against COVID-19. The effect of cyberchondria severity on the utilization of healthcare services and alternative medicine was adjusted for key sociodemographic variables, the presence of chronic diseases, disability, and unspecific symptoms. For variables reflecting the use of services, ordinal logistic regression and multivariable logistic regression models were developed. RESULTS: Cyberchondria severity was a significant predictor of the utilization of all but one of the analyzed healthcare services and alternative medicine. The odds of being in a higher category of the utilization of visits to family physicians and specialists, hospital admissions, emergency services and alternative medicine services increased by a factor of 1.01-1.02 for every unit increase of the cyberchondria score. The cyberchondria score was a negative predictor of COVID-19 vaccine uptake. The effect of cyberchondria on outcome variables was independent of the level of health anxiety, sociodemographic variables, and variables reflecting the health status of respondents. CONCLUSIONS: Cyberchondria leads to more intensive use of nearly all healthcare services, but in the case of vaccination against COVID-19, cyberchondria severity was a negative predictor. Cyberchondria's effect extends beyond health anxiety.

[Health anxiety: Another epidemic to prepare for]. / L'anxiété centrée sur la santé : une autre épidémie à laquelle il faut se préparer.

Health anxiety (HA) is a frequent problem (up to 20% of consultants in the context of secondary care) responsible for decreased well-being, disability, somatic and psychiatric complications, which contributes to high healthcare expenditures at the population level. It is likely, if not definitely established, that the prevalence of ACS is increasing, and this can partly be explained by the growing medicalization of society in general, the appetite of Media for health issues, and the uncontrolled use of the Internet (which can lead certain vulnerable subjects to cyberchondria). The pandemic of COVID-19 could have contributed to it, at least by the significant increase in the overall level of psychological distress in the population it has caused, although this has not formally been demonstrated to date. The diagnosis of ACS is easy, as soon as its assessment is considered as a mandatory part of any medical consultation. Certain intuitive attitudes of doctors, such as reassurance, prove to be iatrogenic for the patient with HA. The management of HA can be facilitated by an acculturation of physicians to cognitive conceptions of anxiety in general and HA in particular. HA is effectively treatable by certain psychotherapy and in the first place cognitive and behavioral therapies (CBT), but the availability of trained therapists and accessible at a lower cost is sorely lacking, particularly in France.

Association between cyberchondria and the use of complementary and alternative medicine (CAM) - a cross-sectional study.

INTRODUCTION AND OBJECTIVE: Cyberchondria has been described relatively recently as a behaviour characterized by excessive Internet searching for medical information related to increasing levels of health anxiety. Complementary and alternative medicine (CAM) refers to a broad set of health care practices that are not part of a country's traditional or conventional medicine, and are not fully integrated into the dominant health care system The aim of this study is to evaluate the relationship between cyberchondria and the use of complementary and alternative medicine. MATERIAL AND METHODS: A cross-sectional study was conducted from 25 April - 25 December 2022. A computer-assisted web interviewing (CAWI) survey technique was used. The study population consisted of 626 respondents who took part in the study. RESULTS: The severity of cyberchondria is associated with 'a greater number of CAM products used' (beta = 0.101; p = 0.043), 'a greater number of self-help techniques used' (beta = 0.210; p<0.001), searching for knowledge about CAM on the Internet (beta-0.199; p<0.001), using sources other than books (beta = -0.114; p = 0.025), younger age (beta = -0.170; p<0.001) and worse education (beta = -0.101; p = 0.033). CONCLUSIONS: The research results indicate that there is a link between cyberchondria and the use of CAM. However, since some components of the CSS-PL scale and self-rated health were not associated with more frequent use of CAM, it is likely that these results may not be fully reliable. The association between cyberchondria and CAM use should be investigated in further studies using comprehensive medical interviews.

Exploring how health-related advertising interference contributes to the development of cyberchondria: A stressor-strain-outcome approach.

Objectives: Cyberchondria is increasingly recognized as the dark side of digital health, given the pervasive use of the internet as a main source of health information in people's daily lives. While previous studies have identified many factors contributing to cyberchondria, there is a dearth of research on the impact of health-related advertisements. Therefore, this study adopts the stressor-strain-outcome (SSO) model to investigate how health-related advertising interference is directly and indirectly related to cyberchondria. Methods: To empirically validate the proposed research model, we conducted an online survey with 437 internet users with medical information seeking experience in China. Structural equation modeling (SEM) was employed to analyze the survey data. Results: Our findings revealed a positive, direct association between health-related advertising interference and cyberchondria. Meanwhile, advertising interference was positively related to both information overload and information irrelevance, with the former further predicting cyberchondria. Moreover, doctor-patient communication weakened the positive effect of information overload on cyberchondria. Conclusions: The study not only theoretically contributes to the literature by theorizing the relationship between health-related advertising interference and cyberchondria but also practically underlines the pivotal role of effective doctor-patient communication in reducing the development of cyberchondria.

Can't stop, won't stop - understanding anxiety's role in cyberchondria among pregnant women.

Online health research is common during pregnancy, especially if women are facing complications. Given the unpleasant emotions women experience after research, it is surprising that cyberchondria, excessive and repeated online health research caused by anxiety that intensifies such anxiety, has not been studied in pregnant women. Therefore, the aim of this study was to examine the predictors of cyberchondria among women with and without pregnancy complications, accounting for health anxiety (a worry regarding personal health) and pregnancy-specific anxiety (concerns related to pregnancy and childbirth). A total of 360 pregnant women completed a questionnaire consisted of Short Health Anxiety Inventory, Pregnancy Concerns Scale and Short Cyberchondria Scale. The results of one-way MANOVA showed that women who had medically complicated pregnancy had higher levels of health anxiety, pregnancy-specific anxiety and cyberchondria compared to those without complications. A hierarchical multiple regression analysis showed that health anxiety and pregnancy-specific anxiety were predictors of cyberchondria but had different roles depending on complications. Pregnancy-specific anxiety predicted cyberchondria in both groups above health anxiety. Health anxiety predicted cyberchondria only in women without complications. In conclusion, women with complications have a higher chance of experiencing cyberchondria. Pregnancy-specific and health anxiety are risk factors for cyberchondria in pregnant women.

The Moderating Role of Health Literacy and Health Promoting Behavior in the Relationship Among Health Anxiety, Emotional Regulation, and Cyberchondria.

Background: People are increasingly turning to the internet to find answers to their health concerns in an era where there is a wealth of online health information, which frequently causes increased health anxiety and the phenomenon known as cyberchondria. The objectives of this study were to examine the moderating role of health literacy and health promotion behavior and the mediating role of emotional regulation between health anxiety and cyberchondria among the Pakistani population. Methods: The study used a self-administered questionnaire to collect and examine health anxiety, emotional regulation, health literacy, health promotion behavior, and cyberchondria in 755 residents. A moderated mediation model of Hayes PROCESS was used to examine this hypothesis. Results: The findings unveiled the average score of the participants on the study variables, as well as their categorization into low, moderate, and high categories. On scale of Health Anxiety participant scores (32% vs 53% vs 15%), Emotional Regulation (25% vs 46% vs 29%), Cyberchondria (18% vs 41% vs 41%), Health Literacy (56% vs 29% vs 15%), and Health promotion Behavior (49% vs 28% vs 23%). Moreover, result revealed that emotional regulation mediates the significant positive association between health anxiety and cyberchondria (ß=0.25**p<0.001). Furthermore, health literacy moderates the negative association health anxiety and emotional regulation (ß=-0.42*p<0.031), and health promotion behavior also negatively moderate the relationship between emotional regulation and cyberchondria (ß=-0.27*p<0.22). Conclusion: Based on the findings, it is recommended that health policymakers consider comprehensive national initiatives that focus on educational planning. These initiatives should boost health literacy levels and promote health-related behavior. Additionally, there is urgent need for strict measures to be put in place for monitoring online platforms and websites that spread inaccurate or false health-related information.

Only the anxious ones? Identifying characteristics of symptom checker app users: a cross-sectional survey.

BACKGROUND: Symptom checker applications (SCAs) may help laypeople classify their symptoms and receive recommendations on medically appropriate actions. Further research is necessary to estimate the influence of user characteristics, attitudes and (e)health-related competencies. OBJECTIVE: The objective of this study is to identify meaningful predictors for SCA use considering user characteristics. METHODS: An explorative cross-sectional survey was conducted to investigate German citizens' demographics, eHealth literacy, hypochondria, self-efficacy, and affinity for technology using German language-validated questionnaires. A total of 869 participants were eligible for inclusion in the study. As n = 67 SCA users were assessed and matched 1:1 with non-users, a sample of n = 134 participants were assessed in the main analysis. A four-step analysis was conducted involving explorative predictor selection, model comparisons, and parameter estimates for selected predictors, including sensitivity and post hoc analyses. RESULTS: Hypochondria and self-efficacy were identified as meaningful predictors of SCA use. Hypochondria showed a consistent and significant effect across all analyses OR: 1.24-1.26 (95% CI: 1.1-1.4). Self-efficacy OR: 0.64-0.93 (95% CI: 0.3-1.4) showed inconsistent and nonsignificant results, leaving its role in SCA use unclear. Over half of the SCA users in our sample met the classification for hypochondria (cut-off on the WI of 5). CONCLUSIONS: Hypochondria has emerged as a significant predictor of SCA use with a consistently stable effect, yet according to the literature, individuals with this trait may be less likely to benefit from SCA despite their greater likelihood of using it. These users could be further unsettled by risk-averse triage and unlikely but serious diagnosis suggestions. TRIAL REGISTRATION: The study was registered in the German Clinical Trials Register (DRKS) DRKS00022465, DERR1- https://doi.org/10.2196/34026 .