STUDY ON PREVALENCE OF CYBERCHONDRIA

AMONG NON- MEDICAL STUDENTS IN CHENNAI

STUDENT: Ms. KAREPALLY JOYCE

REG NO: RA1921001010007

GUIDE: Prof. KAMALANATHAN .P, MPT(Community Physiotherapy )

In partial fulfillment of the requirement for the degree of

BACHELOR OF PHYSIOTHERAPY
June -2023
A Project submitted to

SRM COLLEGE OF PHYSIOTHERAPY SRM INSTITUTE OF

SCIENCE AND TECHNOLOGY
(Deemed to be University u/s of UGC Act, 1956)

SRM Nagar, Kattankulathur,

Chengalpattu District – 603203 Tamil

Nadu, India.
 STUDY OF PREVALENCE OF CYBERCHONDRIA
AMONG NON- MEDICAL STUDENTS IN CHENNAI

INTERNAL
EXAMINER:

Name _____________________________________

Signature with date _____________________________________

EXTERNAL EXAMINER:

Name ______________________________________

Signature with date _____________________________________

In partial fulfillment of the requirement for the degree of

BACHELOR OF PHYSIOTHERAPY

June -2023
A Pro\ ject

submitted to

SRM COLLEGE OF PHYSIOTHERAPY SRM INSTITUTE OF

SCIENCE AND TECHNOLOGY
(Deemed to be University u/s of UGC Act, 1956)

SRM Nagar, Kattankulathur,

Chengalpattu District – 603203Tamil Nadu, India.

 SRM COLLEGE OF PHYSIOTHERAPY SRM
INSTITUTE OF SCIENCE AND TECHNOLOGY
(Deemed to be University u/s 3 of UGC Act, 1956)
SRM Nagar, Kattankulathur – 603203

Chengalpattu (Dt), Tamil Nadu, India.

044- 27456729/ www.srmuniv.ac.in

CERTIFICATE
This is to certify that Ms. KAREPALLY JOYCE, RA1921001010007 has satisfactorily

completed her project on the topic “STUDY ON PREVALENCE OF CYBERCHONDRIA

AMONG NON -MEDICAL STUDENTS IN CHENNAI”. This project is submitted towards

partial fulfillment of Degree of Bachelor of Physiotherapy Examination, – June 2023.

OFFICIAL SEAL WITH DATE DEAN

 SRM COLLEGE OF PHYSIOTHERAPY SRM
INSTITUTE OF SCIENCE AND TECHNOLOGY
(Deemed to be University u/s 3 of UGC Act, 1956)
SRM Nagar, Kattankulathur – 603203

Chengalpattu (Dt), Tamil Nadu, India.

044- 27456729/ www.srmuniv.ac.in

DECLARATION BY THE STUDENT

I hereby declare that this project entitled “STUDY ON PREVALENCE OF
CYBERCHONDRIA AMONG NON -MEDICAL STUDENTS IN CHENNAI ” is a
bonafide and genuine research work carried out by me under the guidance of PROF.
KAMALANTHAN .
P , MPT .

SIGNATURE OF THE STUDENT

CERTIFICATE BY THE GUIDE

This is to certify that the project entitled “STUDY ON PREVALENCE OF
CYBERCHONDRIA AMONG NON - MEDICAL STUDENTS IN CHENNAI” is a
bonafide research work done by MS. KAREPALLY JOYCE towards partial fulfillment of the
requirement for the Degree of Bachelor of Physiotherapy.

DATE:
PLACE: SIGNATURE OF THE GUIDE
 ACKNOWLEDGEMENT

First and foremost, I would like to thank the almighty, who showed his blessings in all walks of
my life.

I submit my Heartful thanks to Prof. T.S.VEERAGOUDHAMAN, M.P.T., DEAN, for the

valuable advice and guidance towards this work.

I would like to thank Mr. T.N. SURESH, M.P.T., VICE PRINCIPAL, for helping me with my
project work.

I am highly indebted to my guide Prof. KAMALANATHAN .P, M.P.T. , who took his real
personal interest in providing me proper guidance, encouragement and support at all levels.

I thank my Coordinator Mr. AYYAPAN JAYAVEL, M.P.T., ASSOCIATE PROFESSOR,

and all my Assistant Professors who with all patience gave me helping hands whenever I needed.

My grateful thanks to all my subject Staff, who contributed their time and energy in this project.

I also thank the subjects who have given their consent for participating in my study and
cooperating till the procedure is been completed.

My entire effort stand credited at this moment only because of my family who whole heartedly
stood beside me always in each step of my career.

Last but not least, I would like to thank all my Friends for their valuable suggestions and
support in the completion of my project.

I DEDICATE THIS PROJECT TO PARENTS

 ABSTRACT

BACKGROUND: The internet has developed into a crucial tool for daily living .
Accessing medical information from online sources may not be beneficial to the
average person .Cyberchondria is the term for anxiety brought on by excessive
online research for medical information . OBJECTIVE: To find the prevalence of
cyberchondria among non-medical students in Chennai. METHODS: 400 subjects
were selected based on inclusion and exclusion criteria. After obtained informed
consent from the patients were instructed to fill the questionnaire. In contrast,
compared to the Excessiveness and Reassurance subscales, the prior investigations
(Fergus, 2014; McElroy & Shevlin, 2014) identified larger connections between the
Mistrust subscale and the Compulsion and Distress subscales. This further supports
the idea that the Mistrust subscale should be viewed as a construct distinct from
General Cyberchondria as measured by the CSS. The CSS failed to replicate the
previously found, and relatively small, relationships between the Mistrust subscale
and the other CSS subscales. (Fergus, 2014). RESULTS: The score distribution of
the sample in the four sub-scales , namely ,compulsivity (mean 8.94; standard
deviation 3.04) , Distress (mean 8.82; standard deviation 3.10), Excessiveness (mean
8.43; standard deviation 4.17), and Reassurance (mean 8.71;standard deviation 3.11)
. CONCLUSION: The study concludes that, Non- medical students in Chennai have
a significant prevalence of cyberchondria leading to notable decline in their mental
health causing depression ,anxiety ,stress disorder which intern give rise to irrational
drug usage negatively impacting quality of their life.

KEYWORDS: Cyberchondria , Health anxiety, Obsessive , repeated online

searches , Mental health .
S.NO CONTENTS PAGE
NO.

1. INTRODUCTION

2. REVIEW OF LITERATURE

3. METHODS

4. DATA ANALYSIS

5. RESULTS

6. DISCUSSION

7. CONCLUSION

8. LIMITATIONS AND RECOMMENDATIONS

9. REFERENCES
10. ANNEXURES

INTRODUCTION

Cyberchondria is a term used to describe the excessive and frequently

unreasonable use of internet to research health issues . Students may experience
it more since they are more likely to spend time online and are more prone to be
anxious about health. Cyberchondria is a phrase used to explain excessive
health worry , obsessive - compulsive disorder , and hypochondriasis. The
diagnosis of cyberchondria as a different clinical entity is warranted ,
nonetheless , because several investigations have demonstrated the clear
distinctions between it and these other diseases .

Cyberchondria can be brought on by a number of factors , from isolated

traumatic incidents to long - term untreated stress .Up-to 9% of people are
thought to have some level of physical symptom - related worry .20% of
people, regardless of symptoms , worry about their health .Online medical
research is popular because it is simple , produces findings quickly , is
anonymous and avoids administrative red tape . Almost any query can be made
without embarrassment . The most significant benefit of getting health
information online is the feeling of empowerment that comes with it , not
necessarily because it is inexpensive or free . This may make it easier for you
to communicate with doctors and enable you to take part more actively in any
conversations about your diagnosis , care , and treatment .

The characteristics of Cyberchondria are present in those who have it . A

needless compulsive information quest searching - related distress including
anxiety and panic investing excessive effort in online research obtaining
confirmation from a reliable source or person a lack of confidence in medical
specialist whose opinion might be sought in person . However , the Internet's
technological advancement also appears to have certain drawbacks .
Cyberchondria , which involves excessively repeating health- related internet
searches , is a phenomenon .The Cyberchondria severity scale [ CSS ]
measures showed substantial correlation with health anxiety appropriate
internal consistency . The only CSS scales that share a specific variance with
health anxiety were the scales measuring discomfort expressiveness , and
 mistrust of medical professionals . These scales show a substantially stronger
correlation with health anxiety than with obsessive - compulsive symptoms .

To enable a holistic evaluation , Mc Elroy and Shevlin [2014] created the 33 -

item cyberchondria severity scale[ CSS ] [compulsion , distress , excessiveness ,
reassurance , and mistrust of medical professional ] .All of these elements as well
as a sub-scale measuring mistrust of medical professional make up the CSS ,which
was previously created and validated .The mistrust in medical professional sub-
scale should be eliminated , according to further validation studies of the scale .
The CSS reduced version is a reliable and accurate indicator of the severity of
cyberchondria
.
 AIM OF THE STUDY
To assess the prevalence of the Cyberchondria among non - medical students in
Chennai.

NEED OF THE STUDY

Nowadays as everyone has a smartphone , self diagnosis as a non-medical
professionals ,over the net leads to a tendency to exaggerate one’s symptoms and
over diagnose oneself due to the array of information present .

There are many studies done on Cyberchondria but few studies done on
prevalence of Cyberchondria in students .

This study is linked with the third sustainable development goal (SDG) to
transform the world i.e good health and wellness of human beings.
 REVIEW OF LITERATURE

Mathes et.al (2018) stated that there is an overuse of medical resources due to the
linkage between cyberchondria and physical impairment.

Singh and brown et.al,(2015) Stated that individual have an escalated anxiety
response following search query .

Mc elroy et.al, (2014) states that CSS is multi - dimensional and even
demonstrates meaningful lower - order dimensions

Laukeret.al (2013) Concluded negative emotions as consequences to

Cyberchondria .

Vladan Starcevic et.al,(2013) stated that a survey reported that a good number of
American adults open - up to the internet for health related queries occasionally .

Lauckner and hseih et.al,(2012) Stated that individuals feel frightened after about
their symptoms .

Baungartner and hastmann et.at,(2011) Has found out that individuals who use
greater frequency of online sources to diagnose themselves as shown greater
anxiety
.

Baungartner and hastmann et.at,(2011) Has found out that individuals who use
greater frequency of online sources to diagnose themselves as shown greater
anxiety
.

Harris poll et.al, (2010) stated that 62% of US adults lack for health information
online , making it fifth most common activity online .

White and Horvite et.al,(2009) Elaborates on the Excessiveness sub -scale of

CSS and concludes it is a key indicator for the escalotory nature of
Cyberchondria .

Ryan and Wilson et.al,(2008) Stated that individual who seeks online related
health esquires are either known to have a increase or decrease in anxiety .
Lemire et.al, (2008) Stated that individual feel empowered after having search
online of their personal health.

Abramowitz et.al, (2007) States that health anxiety is an reflexion of underlying

unfounded personal health anxiety that arises in extremely health conscious people.

Cline and Haynes et.al, (2001) Stated that information available in internet is
poorly organized and contains technical terms and its often not understood by the
general public .

METHODS

STUDY DESIGN : Cross sectional study

STUDY TYPE : Observational
SAMPLING METHOD : Convenient sampling
SAMPLE SIZE : 400 subjects
STUDY SETTING : In and around Chennai

INCLUSION CRITERIA
Those who are non - medical undergraduate student with above 18 years .
Both male and female are included .
Those are mentally sound .
Those are willing to give consent to participate .
 EXCLUSION CRITERIA
Individuals under psychological treatment .
Not present at the study setting for the consecutive of 3 visit .
Subjects who have undergone recent surgeries .

PROCEDURE

This study has been approved by the scientific and ethical committee of SRM
Medical College Hospital And Research Center.

ETHICAL CLEARENCE NUMBER : SRMIEC-ST0922-99

Using convenient sampling 400 participants will be selected based on the selection
criteria .

Study objective will be explained and informed consent will be obtained.

Using self - administered questionnaire which included Cyberchondria severity
scale [ CSS ] data collection will be done .
After that analysis will be done .
There are 5 sub scales used in CSS out of 5 , 4 are chosen for the study .

Using CSS 12 item Questionnaire will have 5 options which will be between 0
[ never ] - 4 [ Always ] .
Score

0 - Not affected

1 -6 -moderately affected

7-12 - severely affected

Each sub scale of the CSS will be treated as separated scales and their mean and
standard deviation score are computed .

Based on the score in each sub scale , the respondents will be classified using K -
means cluster analysis into two groups .
Their confidentiality will be protected by anonymizing the questionnaire and
identifying information , such as the student’s name and personal information .

OUTCOME MEASURE

1. Cyberchondria severity scale (reliability>0.89)

It McElroy and shevlin [2014] developed the multi- dimensional , self report
measure of this construct - Cyberchondria severity scale [CSS] .
• CSS Consists of 33 items and 5 sub scales.
• Using CSS 15 item questionnaire each question will have 5 scores which
will be between 0 [Never ] - 4 [Always ]
Score
0 - Not effected
1 to 6 - Moderately affected
7 to 15- Severely effected
T All 33 -items can be summed to form a total score , and or 5 separate : I ]
Excessiveness ii] Compulsion iii] Distress iv] Reassurance seeking v] Mistrust .
 DATA ANALYSIS

The statistical package for social science (SPSS) version 20 was used to
perform all statistical calculations results with an alpha level below 0.05 were
considered statistically significant.
RESULTS
A total of 400 subjects (200 men and 200 women) were recruited in the study. The
age of subjects ranges above 18 years . Demographic characteristics, the
prevalence of cyberchondria among non-medical students in Chennai scores of
subjects are shown in Table I.

TABLE I
Demographic and clinical characteristics of study participants
Frequenc
Valid Percent
AGE y
(%)
(n)

18 11 2.8

19 11 2.8

20 17 4.3

21 29 7.3

22 311 77.8

23 12 3.0

24 9 2.0

Total 400 100.0

TABLE II

Distribution of subjects according to gender, Cyberchondria severity scale

Frequenc
Valid Percent
y

(%)
AGE (n)

18 11 2.8

19 11 2.8

20 17 4.3

21 29 7.3

22 311 77.9

23 12 3.0
 24 9 2.0

Total 400 100.0

43.1

56.9

male female

Cyberchondria severity scale responses

Statement Never Rarely Sometimes Often Always

If I notice an 7(1.8%) 25(6.3%) 150(37.6%) 21(5.3%) 196(49.1)

unexplained
bodily
sensation I
will search
for it on the
internet
I enter the 8(2%) 21(5.3%) 151(37.8%) 26(6.5%) 193(48.4%)
same
symptoms
into a web
search on
more than
one occasion

Researching 23(5.8%) 29(7.3%) 146(36.6%) 14(3.5%) 186(46.6%)

symptoms or
perceived
medical
conditions
online
interrupts
other
research ( e
g for my
job / college
assignment /
homework)

Researching 26(6.5%) 32(8%) 152(38.1%) 11(2.8%) 178(44.6%)

symptoms
or perceived
medical
conditions
online
interrupts
my online
leisure
activities ( e
g streaming
movies)
I take the 6(1.5%) 7(1.8%) 124(31.1%) 34(8.5%) 228(57.1%)
opinion of
my GP /
medical
professional
more
seriously
than my
online
medical
research

I start to 6(1.5%) 26(6.5) 147(36.8%) 26(6.5%) 194(48.6%)

panic when
I read online
that a
symptom I
have is
found in
rare /
serious
condition

Researching 25(6.3%) 23(5.8%) 141(35.3%) 15(3.8%) 195(48.9%)

symptoms or
perceived
medical
conditions
online
interrupts my
work ( eg
writing
emails ,
working on
words
documents
or
spreadsheets
)
I discuss my 17(4.3%) 15(3.8%) 144(36.1%) 24(6%) 199(49.9%)
online
medical
findings with
my
GP/health
professional

I feel more 11(2.8%) 14(3.5%) 164(41.2%) 21(5.3%) 188(47.2%)

anxious or
distressed
after
researching
symptoms or
perceived
medical
conditions
online

Researching 10(2.5%) 18(4.5%) 141(35.3%) 31(7.8%) 199(49.9%)

symptoms or
perceived
medical
condition
online leads
me consult
with other
medical
specialist (e
g
consultants
)
Discussing 18(4.5%) 26(6.5%) 136(34.1%) 17(4.3%) 202(50.6%)
online info
about a
perceived
medical
condition
with my GP
reassures me

When 1(.3%) 21(5.3%) 140(35.1%) 28(7%) 209(52.4%)

researching
symptoms or
medical
conditions
online I visit
both
trustworthy
websites and
user - driven
forums

I have 13(3.3%) 29(7.3%) 149(37.3%) 17(4.3%) 191(47.9%)

trouble
getting to
sleep after
researching
symptoms
or perceived
medical
conditions
online , as
the findings
play on my
mind
When my 6(1.5%) 12(3%) 133(33.3%) 24(6%) 224(56.1%)
GP / medical
professional
dismisses
my online
medical
research , I
stop
worrying
about it .

Compulsivity
 Distress

Excessiveness
 Reassurance
The score distribution of the sample in
the four sub-scales ,
namely ,compulsivity
(mean 8.94; standard deviation 3.04) , Distress (mean 8.82; standard deviation 3.10),
Excessiveness (mean 8.43; standard deviation 4.17), and Reassurance (mean
8.71;standard deviation 3.11)
 DISCUSSION

Several studies have found that social media and the internet have a significant
impact on students life styles , both socially and in terms of health . Due to the
incorrect information found in internet search results , particularly Cyberchondria ,
students appear to be more likely than other groups of people to have health anxiety
(Starcevic ,2017) . The CSS , created by McElroy and Shelvin ,is anticipated to be a
crucial tool in determining the severity of cyberchondria and its connections to
psychiatric problem (McElroy & Shelvin , 2014 ) The study’s goal is to ascertain
the prevalence of cyberchondria among non -medical students .

This study found that female 55.9% male - of the subjects had some degree of
cyberchondria was inversely connected with the subject’s overall mental health.
Even after controlling for all of these factors , Cyberchondria was still influenced by
the participants overall mental health . None of the socio - demographic parameters
evaluated in this study had any effect on it .
Even after controlling for all of these con founders , none of the socio - demographic
traits examined in this study had any effect on cyberchondria , and cyberchondria
was still influenced by the individual’s overall mental health .As it mentioned in the
introduction , having an anxiety illness , more especially health anxiety , might
indicate poor general mental health . Cyberchondria can also indicate poor general
mental health because of its compulsive tendencies and distressing effects . It can be
challenging to determine which of these cross- sectional research are inferring from
the association . It is obvious that the distress sub-scale scores scores are relatively
low in this sample of people , and as a result , psychological distress has a less
impact on the classification of cyberchondria . As a result , the cyberchondria as
measured by CSS is independently correlated with the psychological discomfort as
measured by the CSS 12 .

CONCLUSION

The study's findings indicate that non-medical students in Chennai have a high
prevalence of cyberchondria, which has a noticeable detrimental influence on their
mental health and causes sadness, anxiety, and stress disorder. This leads to
irrational drug use, which further impairs their quality of life. Therefore this study
aims in creating awareness among in young adults regarding cyberchondria and its
potential damage to the one’s own life . Being an physiotherapist and socially
responsible personal its our duty to explain in detail adverse effect of cyberchondria
and helping them to overcome by counselling or taking necessary steps to prevent
such as relaxation technique .
 LIMITATION

1. Larger sample size can be used

2. Study can be carried out in the medical population
3. Study could not involve mistrust scale
4. Could not analyse additional components prevalence such
as anxiety, or Obsession.

RECOMMENDATION
Future studies can incorporate the use of mistrust scale ,involve medical
students in the study and use a larger sample size.
 REFERENCES

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 ANNEXURE – I

INFORMED CONSENT

I Mr/Ms ________________________ freely and voluntarily agree to participate

in the study conducted on STUDY ON PREVALENCE OF
CYBERCHONDRIA AMONG NON-MEDICAL STUDENTS IN CHENNAI
done by KAREPALLY JOYCE , BPT IV YEAR, SRM COLLEGE OF
PHYSIOTHERAPY, SRM INSTITUTE OF SCIENCE AND
TECHNOLOGY, KATTANKULATHUR, CHENGALPET 603203.
I was explained in detail about the procedure of the study and understood the
requirements and benefits of this study.
I surely solely give consent to participate in this study.
DATE:
SIGNATURE:
PLACE:
 ANNEXURE-II
CYBERCHONDRIA SEVERITY SCALE
Sometimes
Never Rarely
Often Always
1. If I notice an unexplained bodily sensation
1 2 3 4 5
I will search for it on the internet
2. Researching symptoms or perceived medical
conditions online distracts me
1 2 3 4 5 from
reading news/sports/entertainment articles online
3. I read different web pages about the same
perceived condition 1 2 3 4 5
4. I start to panic when I read online that a
symptom I have is found in a rare/serious 1 2 3 4 5 condition

5. Researching symptoms or perceived

medical conditions online leads me to 1 2 3 4 5 consult with my GP

6. I enter the same symptoms into a web

1 2 3 4 5
search on more than one occasion
7. Researching symptoms or perceived medical
conditions online interrupts my
work (e.g. 1 2 3 4 5 writing emails, working on word
documents or spreadsheets)

8. I think I am fine until I read about a serious

condition online 1 2 3 4 5
9. I feel more anxious or distressed after
researching symptoms or perceived 1 2 3 4 5 medical conditions
online
10. Researching symptoms or perceived
medical conditions online interrupts my
offline social activities (e.g. reduces time 1 2 3 4 5
spent with friends/family)
11. I suggest to my GP/medical professional
that I may need a diagnostic procedure
1 2 3 4 5
that I read about online (e.g. a biopsy/ a
specific blood test)
12. Researching symptoms or perceived
medical conditions online leads me to
1 2 3 4 5
consult with other medical specialists (e.g.
consultants)
 ANNEXURE-IX
PLAGIARISM FORM

SRM INSTITUTE OF SCIENCE AND TECHNOLOGY

(Deemed to be University u/s 3 of UGC Act, 1956)
Office of Controller of Examinations

REPORT FOR PLAGIARISM CHECK ON THE PROJECT REPORTS FOR UG PROGRAMMES

1. Name of the KAREPALLY JOYCE

Candidate

2. Address of the 11-204 SIDDHANTHI SHAMSHABD HYDERBAD .

Candidate
Mobile Number: 7416836281
Mobile

3. Registration RA1921001010007
Number
4. Date of Birth 21-01-2000

5. Department SRM College of Physiotherapy

6. Faculty Health Sciences

7. Title of the Project STUDY ON PREVALENCE OF CYBERCHONDRIA

AMONG NON-MEDICAL STUDENTS IN CHENNAI

8. Whether the above INDIVIDUAL

project is done by

9. Name and address PROF.KAMALANTHAN.P PHYSIOTHERAPY), SRM

of the Guide COLLEGE OF PHYSIOTHERAPY

SRM INSTITUTE OF SCIENCE AND TECHNOLOGY.

Mail ID : saravan@srmist.edu.in

Mobile Number : 9841279391

10. Name and address NOT APPLICABLE

of the
Co-Supervisor/
Co-Guide (if any)

11. Software Used TURNITIN

12. Date of 18-04-2023

Verification

13. Plagiarism Details: (to attach the final report from the software)

Enclosed
Title of the study Percentage Percentage % of Plagiarism after
of of excluding Quotes,
similarity similarity Bibliography, etc.,
 index index
(Including (Excluding
self- self-
citation) citation)

STUDY ON PREVALENCE OF
CYBERCHONDRIA AMONG NON- -------- 4% 4%
MEDICAL STUDENTS IN CHENNAI
I / We declare that the above information have been verified and found true to the best of my / our knowledge.

Signature of the Candidate Name & Signature of the Staff

(who uses the Plagiarism check software)

Name & Signature of the Guide Name & Signature of the Co-Supervisor/ Co-Guide

Name & Signature of HOD