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      Effects of Internet Use on Health and Depression: A Longitudinal Study


      , MS 1 , , PhD 2 , , PhD 1 , , PhD 1 ,


      Journal of Medical Internet Research

      Gunther Eysenbach

      Depression, health, social support, Internet, longitudinal survey

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          The rapid expansion of the Internet has increased the ease with which the public can obtain medical information. Most research on the utility of the Internet for health purposes has evaluated the quality of the information itself or examined its impact on clinical populations. Little is known about the consequences of its use by the general population.


          Is use of the Internet by the general population for health purposes associated with a subsequent change in psychological well-being and health? Are the effects different for healthy versus ill individuals? Does the impact of using the Internet for health purposes differ from the impact of other types of Internet use?


          Data come from a national US panel survey of 740 individuals conducted from 2000 to 2002. Across three surveys, respondents described their use of the Internet for different purposes, indicated whether they had any of 13 serious illnesses (or were taking care of someone with a serious illness), and reported their depression. In the initial and final surveys they also reported on their physical health. Lagged dependent variable regression analysis was used to predict changes in depression and general health reported on a later survey from frequency of different types of Internet use at an earlier period, holding constant prior depression and general health, respectively. Statistical interactions tested whether uses of the Internet predicted depression and general health differently for people who initially differed on their general health, chronic illness, and caregiver status.


          Health-related Internet use was associated with small but reliable increases in depression (ie, increasing use of the Internet for health purposes from 3 to 5 days per week to once a day was associated with .11 standard deviations more symptoms of depression, P = .002). In contrast, using the Internet for communication with friends and family was associated with small but reliable decreases in depression (ie, increasing use of the Internet for communication with friends and family purposes from 3 to 5 days per week to once a day was associated with .07 standard deviations fewer symptoms of depression, P = .007). There were no significant effects of respondents’ initial health status ( P = .234) or role as a caregiver ( P = .911) on the association between health-related Internet use and depression. Neither type of use was associated with changes in general health ( P = .705 for social uses and P = .494 for health uses).


          Using the Internet for health purposes was associated with increased depression. The increase may be due to increased rumination, unnecessary alarm, or over-attention to health problems. Additionally, those with unmeasured problems or those more prone to health anxiety may self-select online health resources. In contrast, using the Internet to communicate with friends and family was associated with declines in depression. This finding is comparable to other studies showing that social support is beneficial for well-being and lends support to the idea that the Internet is a way to strengthen and maintain social ties.

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          Most cited references 72

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          Empirical studies assessing the quality of health information for consumers on the world wide web: a systematic review.

          The quality of consumer health information on the World Wide Web is an important issue for medicine, but to date no systematic and comprehensive synthesis of the methods and evidence has been performed. To establish a methodological framework on how quality on the Web is evaluated in practice, to determine the heterogeneity of the results and conclusions, and to compare the methodological rigor of these studies, to determine to what extent the conclusions depend on the methodology used, and to suggest future directions for research. We searched MEDLINE and PREMEDLINE (1966 through September 2001), Science Citation Index (1997 through September 2001), Social Sciences Citation Index (1997 through September 2001), Arts and Humanities Citation Index (1997 through September 2001), LISA (1969 through July 2001), CINAHL (1982 through July 2001), PsychINFO (1988 through September 2001), EMBASE (1988 through June 2001), and SIGLE (1980 through June 2001). We also conducted hand searches, general Internet searches, and a personal bibliographic database search. We included published and unpublished empirical studies in any language in which investigators searched the Web systematically for specific health information, evaluated the quality of Web sites or pages, and reported quantitative results. We screened 7830 citations and retrieved 170 potentially eligible full articles. A total of 79 distinct studies met the inclusion criteria, evaluating 5941 health Web sites and 1329 Web pages, and reporting 408 evaluation results for 86 different quality criteria. Two reviewers independently extracted study characteristics, medical domains, search strategies used, methods and criteria of quality assessment, results (percentage of sites or pages rated as inadequate pertaining to a quality criterion), and quality and rigor of study methods and reporting. Most frequently used quality criteria used include accuracy, completeness, readability, design, disclosures, and references provided. Fifty-five studies (70%) concluded that quality is a problem on the Web, 17 (22%) remained neutral, and 7 studies (9%) came to a positive conclusion. Positive studies scored significantly lower in search (P =.02) and evaluation (P =.04) methods. Due to differences in study methods and rigor, quality criteria, study population, and topic chosen, study results and conclusions on health-related Web sites vary widely. Operational definitions of quality criteria are needed.
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              Effects of self-focused rumination on negative thinking and interpersonal problem solving.

              Hypotheses about the effects of self-focused rumination on interpretations of events and interpersonal problem solving were tested in 3 studies with dysphoric and nondysphoric participants. Study 1 supported the hypothesis that dysphoric participants induced to ruminatively self-focus on their feelings and personal characteristics would endorse more negative, biased interpretations of hypothetical situations than dysphoric participants induced to distract themselves from their mood, or nondysphoric participants. Study 2 showed that dysphoric participants who ruminated were more pessimistic about positive events in their future than the other 3 groups. Study 3 showed that dysphoric ruminating participants generated less effective solutions to interpersonal problems than the other 3 groups. In Studies 1 and 3, dysphoric ruminating participants also offered the most pessimistic explanations for interpersonal problems and hypothetical negative events. In all 3 studies, dysphoric participants who distracted were as optimistic and effective in solving problems as non-dysphoric participants.

                Author and article information

                J Med Internet Res
                Journal of Medical Internet Research
                Gunther Eysenbach (Centre for Global eHealth Innovation, Toronto, Canada )
                Jan-Mar 2010
                12 March 2010
                : 12
                : 1
                [2] 2Department of Psychology University of Kansas LawrenceUSA
                [1] 1Human-Computer Interaction Institute Carnegie Mellon University PittsburghUSA
                © Katie Bessière, Sarah Pressman, Sara Kiesler, Robert Kraut. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 12.03.2010.  

                This is an open-access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in the Journal of Medical Internet Research, is properly cited. The complete bibliographic information, a link to the original publication on http://www.jmir.org/, as well as this copyright and license information must be included.

                Original Paper


                depression, health, social support, internet, longitudinal survey


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