Exploring the relationship between cyberchondria and suicidal ideation : cross-sectional mediation analysis

Abstract

Background: 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. Objective: 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. Methods: 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 (beta) estimates, along with their 95% CIs, were calculated for all structural paths, adjusting for participants' background characteristics. Results: 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 (beta=.281; P<.001), between psychological distress and suicidal ideation (beta=.504; P<.001), and between cyberchondria and suicidal ideation (beta=.107; P<.001). The indirect effect of cyberchondria on suicidal ideation through psychological distress was also significant (beta=.142; P<.001). Conclusions: 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.