An analysis of online health information on schizophrenia or related conditions: a cross-sectional survey

Mental health-related internet use by people with a diagnosis of chronic psychiatric disorder, attending community mental health centres

BACKGROUND

There is little information on Internet use for obtaining mental health information among individuals with chronic psychiatric disorders, who are receiving services from community mental health centres (CMHCs).

OBJECTIVE

To investigate the mental health information-seeking behaviour of individuals with chronic psychiatric disorders who attend CMHCs.

METHOD

This is a cross-sectional descriptive study. The data was collected by questionnaire (structured interview format) (n = 135 participants). The collected data were analysed with descriptive statistics and chi-square test.

RESULTS

It was found that 75.6% of the participants used the internet to search for information about mental health problems. Although the information retrieved from the internet was frequently or occasionally shared with the mental health team (19.6% and 40.2% of the participants, respectively), general online communication with professionals was rare (93.1% of the participants had not contacted mental health professionals).

CONCLUSIONS

Most participants looked for information about their mental health on the internet. Therefore, mental health professionals should consider how to facilitate professional-patient therapeutic communication, with acknowledged Internet use by individuals with chronic psychiatric disorders.

Feasibility, Acceptability, and Preliminary Impacts of Web-Based Patient Education on Patients With Schizophrenia Spectrum Disorder: Quasi-Experimental Cluster Study

BACKGROUND

Web-based interventions are promising tools for increasing the understanding of illness and treatment among patients with serious mental disorders.

OBJECTIVE

This study aimed to test the feasibility and acceptability of a Web-based patient education intervention using a quasi-experimental cluster design to report feedback on patient education sessions and the website used and to report preliminary evidence of the intervention's impact on patients with schizophrenia spectrum disorder.

METHODS

A single-blind, parallel, quasi-experimental cluster study over a 6-month period comparing Web-based education (n=33) with a nonequivalent control group (treatment as usual, n=24) for people with schizophrenia spectrum disorder was conducted. Participants (N=57) were recruited from one psychiatric hospital (6 wards). Feasibility was assessed by participants' commitment (refusal rate, dropout rate) to the study. Acceptability was assessed as participants' commitment to the intervention. Patient education sessions and website feedback were assessed by the patients and health care professionals. The preliminary impact of the sessions on patients' self-efficacy, self-esteem, illness cognition, and knowledge level was measured at baseline and follow-ups (8 weeks, 6 months) with self-rated questionnaires.

RESULTS

The refusal rate among patients was high with no statistically significant difference (69% [74/107] in the intervention group, 76% [76/100] in the control group; P=.21). The same result was found for the dropout rates (48% [16/33] vs 58% [14/24]; P=.46). The acceptability of the intervention was good; 31 participants out of 33 (94%) completed all five sessions. Feedback on the intervention was mainly positive; three out of four subscales of session were rated above the midpoint of 4.0. Feedback on the website was also positive, with a grade of good for content (69%, 20/29 patients; 75%, 21/28 professionals), layout (62%, 18/29 patients; 61%, 17/28 professionals), and usability (62%, 18/29 patients; and 68%, 19/28 professionals). The patients using the intervention had significantly higher scores 6 months after the sessions in self-efficacy (baseline mean 26.12, SD 5.64 vs 6-month mean 29.24, SD 6.05; P=.003) and regarding knowledge level about schizophrenia (mean 11.39, SD 4.65 vs 6-month mean 15.06, SD 5.26; P=.002), and lower scores in the subscale of helplessness in illness cognition (mean 2.26, SD 0.96 vs 6-month mean 1.85, SD 0.59; P=.03). Differences from the control group were not significant. No differences were found in patients' self-esteem or other subscales in illness cognition.

CONCLUSIONS

The patients were reluctant to participate in the study and tended to drop out before the follow-ups. Once they had participated, their acceptance of the intervention was high. A more effective recruitment strategy and monitoring method will be needed in future studies. To assess the impact of the intervention, a more rigorous study design with an adequately powered sample size will be used in cooperation with outpatient mental health services.

Segmentation and texture analysis of structural biomarkers using neighborhood-clustering-based level set in MRI of the schizophrenic brain

OBJECTIVE

Schizophrenia (SZ) is a psychiatric disorder that especially affects individuals during their adolescence. There is a need to study the subanatomical regions of SZ brain on magnetic resonance images (MRI) based on morphometry. In this work, an attempt was made to analyze alterations in structure and texture patterns in images of the SZ brain using the level-set method and Laws texture features.

MATERIALS AND METHODS

T1-weighted MRI of the brain from Center of Biomedical Research Excellence (COBRE) database were considered for analysis. Segmentation was carried out using the level-set method. Geometrical and Laws texture features were extracted from the segmented brain stem, corpus callosum, cerebellum, and ventricle regions to analyze pattern changes in SZ.

RESULTS

The level-set method segmented multiple brain regions, with higher similarity and correlation values compared with an optimized method. The geometric features obtained from regions of the corpus callosum and ventricle showed significant variation (p < 0.00001) between normal and SZ brain. Laws texture feature identified a heterogeneous appearance in the brain stem, corpus callosum and ventricular regions, and features from the brain stem were correlated with Positive and Negative Syndrome Scale (PANSS) score (p < 0.005).

CONCLUSION

A framework of geometric and Laws texture features obtained from brain subregions can be used as a supplement for diagnosis of psychiatric disorders.

Connectivity to computers and the Internet among patients with schizophrenia spectrum disorders: a cross-sectional study

PURPOSE

Information and communication technologies have been developed for a variety of health care applications and user groups in the field of health care. This study examined the connectivity to computers and the Internet among patients with schizophrenia spectrum disorders (SSDs).

PATIENTS AND METHODS

A cross-sectional survey design was used to study 311 adults with SSDs from the inpatient units of two psychiatric hospitals in Finland. The data collection lasted for 20 months and was done through patients' medical records and a self-reported, structured questionnaire. Data analysis included descriptive statistics.

RESULTS

In total, 297 patients were included in this study (response rate =96%). More than half of them (n=156; 55%) had a computer and less than half of them (n=127; 44%) had the Internet at home. Of those who generally had access to computers and the Internet, more than one-fourth (n=85; 29%) used computers daily, and >30% (n=96; 33%) never accessed the Internet. In total, approximately one-fourth of them (n=134; 25%) learned to use computers, and less than one-third of them (n=143; 31%) were known to use the Internet by themselves. Older people (aged 45-65 years) and those with less years of education (primary school) tended not to use the computers and the Internet at all (P<0.001), and younger people and those with higher education were associated with more active use.

CONCLUSION

Patients had quite good access to use computers and the Internet, and they mainly used the Internet to seek information. Social, occupational, and psychological functioning (which were evaluated with Global Assessment of Functioning) were not associated with access to and frequency of computer and the Internet use. The results support the use of computers and the Internet as part of clinical work in mental health care.

How Do People Experiencing Schizophrenia Spectrum Disorders or Other Psychotic Disorders Use the Internet to Get Information on Their Mental Health? Literature Review and Recommendations

BACKGROUND

Studies show that the Internet has become an influential source of information for people experiencing serious psychiatric conditions such as schizophrenia spectrum disorders or other psychotic disorders, among which the rate of Internet users is growing, with rates ranging from 33.3% to 79.5% given the country. Between 20.5% and 56.4% of these Internet users seek mental health information.

OBJECTIVE

Focusing on this population's Web searches about their mental health, this paper examines what type of content they look for and what could be the benefits and disadvantages of this navigation.

METHODS

We conducted a literature review through medical and psychological databases between 2000 and 2015 using the keywords "Internet," "Web," "virtual," "health information," "schizophrenia," "psychosis," "e-mental health," "e-support," and "telepsychiatry."

RESULTS

People experiencing schizophrenia spectrum disorders or other psychotic disorders wish to find on the Internet trustful, nonstigmatizing information about their disease, flexibility, security standards, and positive peer-to-peer exchanges. E-mental health also appears to be desired by a substantial proportion of them. In this field, the current developments towards intervention and early prevention in the areas of depression and bipolar and anxiety disorders become more and more operational for schizophrenia spectrum disorders and other psychotic disorders as well. The many benefits of the Internet as a source of information and support, such as empowerment, enhancement of self-esteem, relief from peer information, better social interactions, and more available care, seem to outbalance the difficulties.

CONCLUSIONS

In this paper, after discussing the challenges related to the various aspects of the emergence of the Internet into the life of people experiencing schizophrenia spectrum disorders or other psychotic disorders, we will suggest areas of future research and practical recommendations for this major transition.

Quality and accuracy of publicly accessible cancer-related physical activity information on the Internet: a cross-sectional assessment

In this study, we assessed the quality of publicly available cancer-related physical activity (PA) information appearing on reputable sites from Canada and other English-speaking countries. A cross-sectional Internet search was conducted on select countries (Canada, USA, Australia, New Zealand, UK) using Google to generate top 50 results per country for the keywords "'physical activity' AND 'cancer'". Top results were assessed for quality of PA information based on a coding frame. Additional searches were performed for Canadian-based sites to produce an exhaustive list. Results found that many sites offered cancer-related PA information (94.5%), but rarely defined PA (25.2%). Top 50 results from each country did not differ on any indicator examined. The exhaustive list of Canadian sites found that many sites gave information about PA for survivorship (78.3%) and prevention (70.0%), but rarely defined (6.7%) or referenced PA guidelines (28.3%). Cancer-related PA information is plentiful on the Internet but the quality needs improvement. Sites should do more than mention PA; they should provide definitions, examples and guidelines. With improvements, these websites would enable healthcare providers to effectively educate their patients about PA, and serve as a valuable resource to the general public who may be seeking cancer-related PA information.

A questions-based investigation of consumer mental-health information

Despite the wealth of mental-health information available online to consumers, research has shown that the mental-health information needs of consumers are not being met. This study contributes to that research by soliciting consumer questions directly, categorizing them, analyzing their form, and assessing the extent to which they can be answered from a trusted and vetted source of online information, namely the website of the US National Institute of Mental Health (NIMH). As an alternative to surveys and analyses of online activity, this study shows how consumer questions provide new insight into what consumers do not know and how they express their information needs. The study crowdsourced 100 consumer questions through Amazon Inc.'s Mechanical Turk. Categorization of the questions shows broad agreement with earlier studies in terms of the content of consumer questions. It also suggests that consumers' grasp of mental health issues may be low compared to other health topics. The majority of the questions (74%) were simple in form, with the remainder being multi-part, multifaceted or narrative. Even simple-form questions could, however, have complex interpretations. Fifty four questions were submitted to the search box at the NIMH website. For 32 questions, no answer could be found in the top one to three documents returned. Inadequacies in the search and retrieval technology deployed at websites account for some of the failure to find answers. The nature of consumer questions in mental health also plays a role. A question that has a false presupposition is less likely to have an answer in trusted and vetted sources of information. Consumer questions are also expressed with a degree of specificity that makes the retrieval of relevant information difficult. The significance of this study is that it shows what an analysis of consumer mental-health questions can tell us about consumer information needs and it provides new insight into the difficulties facing consumers looking for answers to their questions in online resources.