Reddit Users' Experiences of Suicidal Thoughts During the COVID-19 Pandemic: A Qualitative Analysis of r/Covid19_support Posts

Social media users' perspectives of spinal cord stimulation: an analysis of data sourced from social media

OBJECTIVES

To identify Reddit users' viewpoints and inquiries about spinal cord stimulation (SCS) for chronic back pain using Reddit databases.

METHODS

We performed a qualitative analysis of public, anonymous threads and comments from targeted subreddits within the Reddit community. We used the Python Reddit API Wrapper to extract relevant data. A qualitative descriptive approach was employed, using natural language processing to identify and categorize common questions, concerns, and opinions shared by patients regarding SCS.

RESULTS

Our analysis included 112 posts and 448 comments. The tone of comments was neutral (n=231), followed by negative (n=121) and positive (n=96). 13 users actively encouraged other users to try the procedure, while 25 advised against it. The main topics of discussions revolved around pain relief expectations and adverse events. Almost half of users commenting about pain relief expectations reported experiencing considerably lower improvement than anticipated. Pocket pain, lead fracture/migration, infection risk, and scars were common topics of discussion among users. Furthermore, users shared strategies to mitigate postoperative discomfort and offered insights into device selection based on MRI conditionality, reprogramming need, and charging prerequisites.

CONCLUSION

Our Reddit analysis identified potential targets for enhanced dialog between physicians and patients around anticipated pain relief, complications, and postoperative care. Reddit and other social media platforms may offer valuable opportunities for healthcare professionals to improve engagement with patients.

'There is no justice in nursing school': A qualitative analysis of nursing students' experiences of discrimination shared on Reddit

AIM

To explore nursing students' experiences of stigma and discrimination within nursing programmes as shared on Reddit, and how other Reddit users offer support and guidance.

DESIGN

Qualitative interpretive description.

METHODS

Through a critical social theory lens, this study draws on students' posts from three nursing subreddits: r/studentnurse, r/nursingstudent and r/nursing. Data were collected from March 2013 to March 2023. Reflexive thematic analysis was conducted to generate broad themes of nursing students' experiences of stigma and discrimination, and how other Reddit users offered support and guidance.

RESULTS

A total of 43 posts with 1412 associated comments were included in this analysis, which generated three predominant themes of nursing students' experiences. Nursing students faced stigma and discrimination across contexts, including from peers, nurses and other healthcare providers working in clinical practicum sites, and patients. Nursing students' posts described navigating the impacts and consequences of such experiences, including on well-being, and programme and career success. In contexts where students were often alone in their experiences of stigma and discrimination within their programmes and with few identified supports, Reddit users sought support and community through Reddit. While many comments offered validation and support, challenges of this social media platform included conflicting advice and unhelpful, judgmental messages.

CONCLUSIONS

Despite widely articulated social justice commitments in the profession, nursing students continue to experience stigma and discrimination across contexts within their nursing programmes.

IMPLICATIONS FOR PROFESSION

Nurses and nurse educators have a responsibility to acknowledge and make visible such experiences, and take direct action to prevent and remediate stigma and discrimination within nursing education.

IMPACT

This research contributes to the growing empirical evidence that nursing students' experience stigma and discrimination within nursing programmes and the healthcare system.

REPORTING METHOD

Adherence to COREQ guidelines was maintained.

PATIENT OR PUBLIC CONTRIBUTION

No patient or public contribution.

"I don't wanna die, but my brain insists that I should": a big qualitative data approach to the lived experiences of suicidal thoughts

Introduction

There remains a dearth of knowledge concerning the phenomenology of suicidal thoughts, with research focusing on reasons for feeling suicidal rather than their mental expression. While clinical interviews remain the standard phenomenological approach, such exploration of lived experiences may prove challenging for this sensitive topic. As a complementary alternative, the use of naturally-occurring online data is opportune for capturing elaborations on tabooed phenomena.

Methods

In this phenomenological study, we present a thematic analysis on lived experiences of suicidal thoughts as spontaneously reported by non-identified users of a Reddit online board (r/Depression), collecting 668 posts using the search terms "suicidal ideation," "suicidal thoughts," and "suicide." Codes were grouped into descriptive categories summarizing the properties of thoughts, their effects, and their relation to suicide. Then, an interpretative synthesis yielded global themes connecting salient meanings on the experience of suicidal thoughts.

Results

With a long-term and recurring nature, thoughts of suicide appear in the form of vivid imagery and daydreaming's, initially bringing relief to adverse feelings but eventually becoming conditioned and all-consuming. Rather than a wonderment, they are experienced as intrusive thoughts by people struggling to make meaning of their occurrence. When conciliating the presence of unwanted thoughts, users express intricate relations to wishing or not to die, as well as varying perceptions of control over actions or fear of suicidal behavior.

Discussion

With an innovative application of big qualitative data into phenomenological analysis, this study contributes to an initial characterization of suicidal thoughts, uncovering findings that are not contemplated into current conceptualizations of suicidality. The analysis is limited by a restricted context of posts and unknown demographics, and further research with clinical interviews is warranted for in-depth exploration of suicidal thoughts.

Analysis of user trends in digital health communities using big data mining

Camoni, the largest digital health community in Israel, involves thousands of patients in the decision-making process concerning their illness and treatment. This approach reflects the recent global shift towards digital tools that combine professional information with social networking capabilities to enable problem-solving, emotional support, and knowledge sharing. Digital health communities serve as an invaluable resource for individuals seeking to learn more about their health, connect with others with shared experiences, and receive encouragement. Our research investigates user trends in digital health communities using the Camoni platform as a case study. To this end, we compile a comprehensive database of 12 years of site activity and conduct a large-scale analysis to identify and assess significant trends in user behavior. We observe several significant trends concerning different genders engagement and note a narrowing of gaps between men and women users' participation and publication volume. Furthermore, we find that younger users have become increasingly active on the platform over time. We also uncover unique gender-specific behavior patterns that we attempt to characterize and explain. Our findings suggest that the rise of digital health communities has accelerated in recent years, reflecting the public's growing preference to take a more active role in their medical care.

Identifying Reddit Users at a High Risk of Suicide and Their Linguistic Features During the COVID-19 Pandemic: Growth-Based Trajectory Model

BACKGROUND

Suicide has emerged as a critical public health concern during the COVID-19 pandemic. With social distancing measures in place, social media has become a significant platform for individuals expressing suicidal thoughts and behaviors. However, existing studies on suicide using social media data often overlook the diversity among users and the temporal dynamics of suicide risk.

OBJECTIVE

By examining the variations in post volume trajectories among users on the r/SuicideWatch subreddit during the COVID-19 pandemic, this study aims to investigate the heterogeneous patterns of change in suicide risk to help identify social media users at high risk of suicide. We also characterized their linguistic features before and during the pandemic.

METHODS

We collected and analyzed post data every 6 months from March 2019 to August 2022 for users on the r/SuicideWatch subreddit (N=6163). A growth-based trajectory model was then used to investigate the trajectories of post volume to identify patterns of change in suicide risk during the pandemic. Trends in linguistic features within posts were also charted and compared, and linguistic markers were identified across the trajectory groups using regression analysis.

RESULTS

We identified 2 distinct trajectories of post volume among r/SuicideWatch subreddit users. A small proportion of users (744/6163, 12.07%) was labeled as having a high risk of suicide, showing a sharp and lasting increase in post volume during the pandemic. By contrast, most users (5419/6163, 87.93%) were categorized as being at low risk of suicide, with a consistently low and mild increase in post volume during the pandemic. In terms of the frequency of most linguistic features, both groups showed increases at the initial stage of the pandemic. Subsequently, the rising trend continued in the high-risk group before declining, while the low-risk group showed an immediate decrease. One year after the pandemic outbreak, the 2 groups exhibited differences in their use of words related to the categories of personal pronouns; affective, social, cognitive, and biological processes; drives; relativity; time orientations; and personal concerns. In particular, the high-risk group was discriminant in using words related to anger (odds ratio [OR] 3.23, P<.001), sadness (OR 3.23, P<.001), health (OR 2.56, P=.005), achievement (OR 1.67, P=.049), motion (OR 4.17, P<.001), future focus (OR 2.86, P<.001), and death (OR 4.35, P<.001) during this stage.

CONCLUSIONS

Based on the 2 identified trajectories of post volume during the pandemic, this study divided users on the r/SuicideWatch subreddit into suicide high- and low-risk groups. Our findings indicated heterogeneous patterns of change in suicide risk in response to the pandemic. The high-risk group also demonstrated distinct linguistic features. We recommend conducting real-time surveillance of suicide risk using social media data during future public health crises to provide timely support to individuals at potentially high risk of suicide.

Examining Symptoms of Stimulant Misuse and Community Support Among Members of a Recovery-Oriented Online Community

Misuse of prescription and non-prescription stimulants and related overdose deaths represent a growing public health crisis that warrants immediate intervention. We examined 100 posts and their respective comments from a public, recovery-oriented Reddit community in January 2021 to explore content related to DSM-V stimulant use disorder symptoms, access and barriers to recovery, and peer support. Using inductive and deductive methods, a codebook was developed with the following primary themes: 1) DSM-V Symptoms and Risk Factors, 2) Stigma/Shame, 3) Seeking Advice or Information, 4) Supportive or Unsupportive Comments. In 37% of posts community members reported taking high doses and engaging in prolonged misuse of stimulants. Nearly half of posts in the sample (46%) were seeking advice for recovery, but 42% noted fear of withdrawal symptoms or a loss of productivity (18%) as barriers to abstinence or a reduction in use. Concerns related to stigma, shame, hiding use from others (30%), and comorbid mental health conditions (34%) were also noted. Social media content analysis allows for insight into information about lived experiences of individuals struggling with substance use disorders. Future online interventions should address recovery barriers related to stigma and shame as well as fears associated with the physical and psychological impact of quitting stimulant misuse.

Self-reported Xylazine Experiences: A Mixed-methods Study of Reddit Subscribers

OBJECTIVES

Xylazine is an α 2 -agonist increasingly prevalent in the illicit drug supply. Our objectives were to curate information about xylazine through social media from people who use drugs (PWUDs). Specifically, we sought to answer the following: (1) What are the demographics of Reddit subscribers reporting exposure to xylazine? (2) Is xylazine a desired additive? And (3) what adverse effects of xylazine are PWUDs experiencing?

METHODS

Natural language processing (NLP) was used to identify mentions of "xylazine" from posts by Reddit subscribers who also posted on drug-related subreddits. Posts were qualitatively evaluated for xylazine-related themes. A survey was developed to gather additional information about the Reddit subscribers. This survey was posted on subreddits that were identified by NLP to contain xylazine-related discussions from March 2022 to October 2022.

RESULTS

Seventy-six posts were extracted via NLP from 765,616 posts by 16,131 Reddit subscribers (January 2018 to August 2021). People on Reddit described xylazine as an unwanted adulterant in their opioid supply. Sixty-one participants completed the survey. Of those who disclosed their location, 25 of 50 participants (50%) reported locations in the Northeastern United States. The most common route of xylazine use was intranasal use (57%). Thirty-one of 59 (53%) reported experiencing xylazine withdrawal. Frequent adverse events reported were prolonged sedation (81%) and increased skin wounds (43%).

CONCLUSIONS

Among respondents on these Reddit forums, xylazine seems to be an unwanted adulterant. People who use drugs may be experiencing adverse effects such as prolonged sedation and xylazine withdrawal. This seemed to be more common in the Northeast.

Self-harm among youth during the first 28 months of the COVID-19 pandemic in Ontario, Canada: a population-based study

BACKGROUND

Youth have reported worsening mental health during the COVID-19 pandemic. We sought to evaluate rates of pediatric acute care visits for self-harm during the pandemic according to age, sex and mental health service use.

METHODS

We conducted a population-based, repeated cross-sectional study using linked health administrative data sets to measure monthly rates of emergency department visits and hospital admissions for self-harm among youth aged 10-17 years between Jan. 1, 2017, and June 30, 2022, in Ontario, Canada. We modelled expected rates of acute care visits for self-harm after the pandemic onset based on prepandemic rates. We reported relative differences between observed and expected monthly rates overall and by age group (10-13 yr and 14-17 yr), sex and mental health service use (new and continuing).

RESULTS

In this population of about 1.3 million children and adolescents, rates of acute care visits for self-harm during the pandemic were higher than expected for emergency department visits (0.27/1000 population v. 0.21/1000 population; adjusted rate ratio [RR] 1.29, 95% confidence interval [CI] 1.19-1.39) and hospital admissions (0.74/10 000 population v. 0.43/10 000 population, adjusted RR 1.72, 95% CI 1.46-2.03). This increase was primarily observed among females. Rates of emergency department visits and hospital admissions for self-harm were higher than expected for both those aged 10-13 years and those aged 14-17 years, as well as for both those new to the mental health system and those already engaged in care.

INTERPRETATION

Rates of acute care visits for self-harm among children and adolescents were higher than expected during the first 2 and a half years of the COVID-19 pandemic, particularly among females. These findings support the need for accessible and intensive prevention efforts and mental health supports in this population.

Comparing the Discussion of Telehealth in Two Social Media Platforms: Social Listening Analysis

Background

Social media is used as a source of information and platform to discuss health care; however, there is little research on discussion of telehealth in social media. Past research has looked at individual platforms, but a comparison of discussion on two platforms (Reddit and Twitter) has not been performed. Understanding telehealth-related social media discourse and the differences between platforms may provide insights into how telehealth is characterized online and which platforms provide patient perspectives. The COVID-19 pandemic provides a unique case study to examine how social media users approached both Reddit and Twitter during an international health crisis. This study used natural language processing tools and two social media platforms to (1) characterize and contrast each platform's telehealth-related posts according to themes and (2) assess the frequency of telehealth and telehealth-related terms posts before and during the onset of the COVID-19 pandemic.

Methods

We collected 6 years (2016 through 2021) of social media posts from Twitter and Reddit. The themes of the corpus were extracted using hashtags, subreddits, and Latent Dirichlet Allocation (LDA) and were analyzed using descriptive statistics.

Results

Both Twitter and Reddit showed exponential growth in the use of the term "telehealth" and telehealth-related terms in early 2020. The use of telehealth-related terms and discussion of COVID-19 coincided in both social media sites; however, other themes were discussed, including how to use telehealth. Reddit LDA clusters showed greatest usage of "telehealth" when associated with using or suggesting telehealth for receiving therapy, counseling, or psychoanalysis while Twitter focused on sharing telehealth news, products, and services.

Discussion

Twitter and Reddit had extensive growth in the use of telehealth-related terms after the COVID-19 pandemic. Twitter and Reddit showed themes connecting COVID-19 to telehealth, especially in reference to services, therapy, and counseling, however, Reddit had more discussion suggesting use of telehealth services or requesting peer insights into how to use telehealth as compared with Twitter, which appeared more focused on telehealth as a business or product.

Self-reported Xylazine Experiences: A Mixed Methods Study of Reddit Subscribers

Objectives

Xylazine is an alpha-2 agonist increasingly prevalent in the illicit drug supply. Our objectives were to curate information about xylazine through social media from People Who Use Drugs (PWUDs). Specifically, we sought to answer the following: 1) what are the demographics of Reddit subscribers reporting exposure to xylazine? 2) is xylazine a desired additive? and 3) what adverse effects of xylazine are PWUDs experiencing?

Methods

Natural Language Processing (NLP) was used to identify mentions of "xylazine" from posts by Reddit subscribers who also posted on drug-related subreddits. Posts were qualitatively evaluated for xylazine-related themes. A survey was developed to gather additional information about the Reddit subscribers. This survey was posted on subreddits that were identified by NLP to contain xylazine-related discussions from March 2022 to October 2022.

Results

76 posts mentioning xylazine were extracted via NLP from 765,616 posts by 16,131 Reddit subscribers (January 2018 to August 2021). People on Reddit described xylazine as an unwanted adulterant in their opioid supply. 61 participants completed the survey. Of those that disclosed their location, 25/50 (50%) participants reported locations in the Northeastern United States. The most common eoute of xylazine use was intranasal use (57%). 31/59 (53%) reported experiencing xylazine withdrawal. Frequent adverse events reported were prolonged sedation (81%) and increased skin wounds (43%).

Conclusions

Among respondents on these Reddit forums, xylazine appears to be an unwanted adulterant. PWUDs may be experiencing adverse effects such as prolonged sedation and xylazine withdrawal. This appeared to be more common in the Northeast.

The evolution of research on depression during COVID-19: A visual analysis using Co-Occurrence and VOSviewer

Background

The COVID-19 pandemic has led to public health problems, including depression. There has been a significant increase in research on depression during the COVID-19 pandemic. However, little attention has been paid to the overall trend in this field based on bibliometric analyses.

Methods

Co-Occurrence (COOC) and VOSviewer bibliometric methods were utilized to analyze depression in COVID-19 literature in the core collection of the Web of Science (WOS). The overall characteristics of depression during COVID-19 were summarized by analyzing the number of published studies, keywords, institutions, and countries.

Results

A total of 9,694 English original research articles and reviews on depression during COVID-19 were included in this study. The United States, China, and the United Kingdom were the countries with the largest number of publications and had close cooperation with each other. Research institutions in each country were dominated by universities, with the University of Toronto being the most productive institution in the world. The most frequently published author was Ligang Zhang. Visualization analysis showed that influencing factors, adverse effects, and coping strategies were hotspots for research.

Conclusion

The results shed light on the burgeoning research on depression during COVID-19, particularly the relationship between depression and public health. In addition, future research on depression during COVID-19 should focus more on special groups and those at potential risk of depression in the general population, use more quantitative and qualitative studies combined with more attention to scale updates, and conduct longitudinal follow-ups of the outcomes of interventions. In conclusion, this study contributes to a more comprehensive view of the development of depression during COVID-19 and suggests a theoretical basis for future research on public health.

Understanding information needs during COVID-19: A comparison study between an online health community and a Q&A platform

This paper aims at identifying user’s information needs on Coronavirus and the differences of user’s information needs between the online health community MedHelp and the question-and-answer forum Quora during the COVID-19 global pandemic. We obtained the posts in the sub-community Coronavirus on MedHelp (195 posts with 1627 answers) and under the topic of COVID-19(2019-2020) on Quora (263 posts with 8401 answers) via web scraping built on Selenium WebDriver. After preprocessing, we conducted topic modeling on both corpora and identified the best topic model for each corpus based on the diagnostic metrics. Leveraging the improved sqrt-cosine similarity measurement, we further compared the topic similarity between these two corpora. This study finds that there are common information needs on both platforms about vaccination and the essential elements of the disease including the onset symptoms, transmission routes, preventive measures, treatment and control of COVID-19. Some unique discussions on MedHelp are about psychological health, and therapeutic management of patients. Users on Quora have special interests of information about the association between vaccine and Luciferase, and attacks on Fauci after email trove released. The work is beneficial for researchers who aim to provide accurate information assistance and build effective online emergence response programs during the pandemic.

Network Structure and Community Evolution Online: Behavioral and Emotional Changes in Response to COVID-19

Background: The measurement and identification of changes in the social structure in response to an exceptional event like COVID-19 can facilitate a more informed public response to the pandemic and provide fundamental insights on how collective social processes respond to extreme events. Objective: In this study, we built a generalized framework for applying social media data to understand public behavioral and emotional changes in response to COVID-19. Methods: Utilizing a complete dataset of Sina Weibo posts published by users in Wuhan from December 2019 to March 2020, we constructed a time-varying social network of 3.5 million users. In combination with community detection, text analysis, and sentiment analysis, we comprehensively analyzed the evolution of the social network structure, as well as the behavioral and emotional changes across four main stages of Wuhan's experience with the epidemic. Results: The empirical results indicate that almost all network indicators related to the network's size and the frequency of social interactions increased during the outbreak. The number of unique recipients, average degree, and transitivity increased by 24, 23, and 19% during the severe stage than before the outbreak, respectively. Additionally, the similarity of topics discussed on Weibo increased during the local peak of the epidemic. Most people began discussing the epidemic instead of the more varied cultural topics that dominated early conversations. The number of communities focused on COVID-19 increased by nearly 40 percent of the total number of communities. Finally, we find a statistically significant "rebound effect" by exploring the emotional content of the users' posts through paired sample t-test (P = 0.003). Conclusions: Following the evolution of the network and community structure can explain how collective social processes changed during the pandemic. These results can provide data-driven insights into the development of public attention during extreme events.