Hassan Raza Ali
A mother convinced that her child has ADHD and a student certain that he has a medical condition after consulting an AI chatbot, are becoming familiar encounters in Pakistan’s mental health clinics. Both illustrate a growing phenomenon known as cyberchondria: repeated online searches about health that amplify anxiety rather than provide reassurance. The parent’s concern is health anxiety by proxy, but the underlying pattern is similar.
A study published in the Journal of the Pakistan Medical Association (JPMA), involving university students in several Pakistani cities, found that about half experienced moderate cyberchondria, while almost 24 per cent scored in the high range. Alarmingly, 64pc did not verify the accuracy of the health information they accessed. Although the sample was not random and cannot represent the entire population, the researchers identified cyberchondria as a serious public health concern.
Yet the issue remains largely overlooked. A recent study in the Khyber Medical University Journal observed that Pakistani research on cyberchondria remains limited, with most studies focusing on people already diagnosed with medical conditions rather than otherwise healthy individuals searching for answers online.
Artificial intelligence may further aggravate the problem. The JPMA findings predate the widespread use of chatbots. Unlike search engines, which provide links to different sources, AI tools deliver fluent, personalized and seemingly authoritative responses at any hour. Cyberchondria thrives on a cycle of anxiety, searching, temporary reassurance and renewed fear. Chatbots can inadvertently keep this cycle going.
Online health resources and AI tools are not inherently harmful. In a country where medical specialists are scarce, they can provide valuable information. The real danger, however, lies in mistaking information for diagnosis. A child’s inattention, for instance, may result from anxiety, inadequate sleep, learning difficulties, hearing or vision problems or classroom stress. Diagnosing ADHD requires a detailed medical history, observation and information from school, none of which an online checklist or chatbot can adequately provide.
Pakistan’s healthcare system also provides fertile ground for this phenomenon. The absence of an effective first point of contact often drives patients towards major urban hospitals, where queues are long and consultations brief. With more than half of healthcare expenditure paid out of pocket, many people understandably seek free online answers before consulting a doctor.
The consequences may extend beyond anxiety. Self-diagnosis can encourage self-medication, including inappropriate antibiotic use. Although a direct link between cyberchondria and antibiotic misuse remains unproven, anxiety-driven self-diagnosis may reinforce the practice. An Islamabad study found that nearly one-third of participants had used antibiotics without medical advice, frequently taking ciprofloxacin for common complaints such as colds and fever. A 2020 Punjab study found that 96.9pc of pharmacies and medical stores surveyed dispensed antibiotics without prescriptions. Such practices contribute to antimicrobial resistance, a growing threat illustrated by the extensively drug-resistant typhoid outbreak first reported in Sindh in 2016.
Cyberchondria must therefore be treated as a public health concern rather than a personal weakness. Nurses and community health workers should routinely ask patients what health information they have consulted online. Primary healthcare facilities must be strengthened as the first point of contact, while existing prescription requirements for antibiotics should be enforced in collaboration with pharmacists.
A machine may suggest a diagnosis within seconds, but it cannot examine a child, interpret a silence or assume responsibility for a prescription. Unless people learn to recognize this distinction, the price will be paid in crowded clinics, sleepless nights and medicines that increasingly fail to work.
—The writer is a Global Health Researcher at Rawalpindi Medical University.
