# Trends in the Implementation of the Cyberchondria Severity Scale: Bibliometric Analysis

## TL;DR

This paper analyzes how often researchers use two versions of the Cyberchondria Severity Scale in studies from 2019 to 2024.

## Contribution

It provides a bibliometric analysis of the adoption trends and language-specific usage of the CSS and CSS-12.

## Key findings

- 35.9% of articles used the full CSS, while 32.5% used the abbreviated CSS-12.
- There was a significant association between the language of the instrument and the CSS version used.
- Cultural and linguistic factors appear to influence the choice of cyberchondria measurement tools.

## Abstract

Cyberchondria, a combination of the words “cyber” and “hypochondriasis,” is a condition that is receiving increasing attention from clinicians and researchers globally. Researchers are currently using multiple instruments to quantify it. Furthermore, the instruments have been translated into multiple languages.

This study aimed to examine the extent to which researchers are measuring cyberchondria using the 33-item Cyberchondria Severity Scale (CSS) and its 12-item abbreviated version, the CSS-12. It also examined the relative use of cyberchondria instruments in different languages.

PubMed and PsycInfo were searched for articles published between May 1, 2019, and December 31, 2024, featuring the term “cyberchondria” in the title. Included articles mentioned the CSS, were empirical studies, and were in English. Each article was categorized by the CSS version, publication year, and language of instrument implementation. Fisher exact tests were used to assess associations, and the Spearman rank correlation coefficient was used to evaluate trend monotonicity.

Among the 117 articles included in the analysis, 42 (35.9%) used the CSS, 38 (32.5%) used the CSS-12, and the remaining 37 (31.6%) used unknown or modified versions. Although CSS-12 use began with its introduction in 2019, there was no significant association between publication year and instrument choice (P=.84). Unadjusted analysis found that the relationship between year and the percentage of articles using the CSS-12 showed a statistically significant monotonic trend (ρ=0.89; P=.02). This finding was not significant after applying a Bonferroni correction. However, there was a significant association between the language of the instrument and the CSS version used (P<.001).

From 2019 to 2024, both the CSS and CSS-12 continued to be used. The CSS-12 offers benefits such as brevity and the removal of reverse-keyed items, while the original CSS remains useful for studies that require the mistrust of medical professionals subscale. The significant association between language and instrument choice suggests that cultural and linguistic factors impact selection, and instrument choice should be guided by the study’s objectives and the constructs of interest.