Medical blog

 

If you think that every twinge is something sinister, it could be that you habitually check out your symptoms using a free online symptom checker.

We have all turned into citizen diagnosticians thanks to “Doctor Google”. But citizen beware, online symptom checking could cause you to feel much worse.

Research conducted by Edith Cowan University and published in the Medical Journal of Australia recently evaluated 36 online symptom checkers with a range of clinical vignettes (cases). The study found that the correct diagnosis was listed first only one third of the time and appeared within the top three results only 52% of the time. Triage advice was appropriate less than half of the time.

It is well known that the quality of information on the internet varies wildly. Online symptom checkers are no different. They ask users to list their symptoms before offering possible diagnoses. Triage advice is about whether – or how quickly – the user should see a doctor or go to the emergency department.

If an online symptom checker provides a serious but incorrect diagnosis it may send you rushing to the doctor, increasing the drain on already over-burdened family doctors. But the worst outcome of online symptom checkers, the authors say, is to not be able to identify a disease correctly than to get an inaccurate diagnosis.

Emergency or benign ache?

Most of the time online symptom checkers and triage advice recommend more urgent care than is required. This is because their diagnostic accuracy is limited by their programming and how information is presented. Thanks to their complex algorithms, the more symptoms entered the less useful ‘diagnosis’.

If you search for ‘headache’, for example, the chances are you’ll find some form of tumour in the list or the online symptom checker may suggest that your perpetual fatigue could be a sign of cancer.

Cyberchondria?

If you are prone to cyberchondria – the official name for anxiety-driven habitual online symptom checking. Resisting temptation to look up your symptoms could protect you from unreliable results, but self-diagnosing your symptoms could mean overlooking a potentially dangerous disease.

The authors concluded that free online symptom checkers may provide unsuitable advice and not facilitate the right health care at the right time.

For more information, see the original article in the Medical Journal of Australia: 

What are your experiences with free online symptom checkers?

Please comment below.

 

 

Exercise can have an enormous impact on your mood. In fact, it is thought that  exercise is beneficial enough to be recommended as an intervention in combination with other treatment.

But is exercise as effective for depressive symptoms when you also have a physical illness?

A review published recently in Frontiers in Psychiatry showed that exercise improved both the depressive symptoms and the underlying physical condition for a range of physical illnesses including:

Breast cancer
Prostate cancer
Cardiovascular disease
Coronary heart disease
Heart failure
HIV
Multiple sclerosis
Parkinson’s disease
Stroke
Ankylosing spondylitis
Traumatic brain injury
Acute leukemia
Lupus erythematodes
Fibromyalgia

Previously, studies have  shown that the beneficial effects of exercise are shown to be similar to treatment with medication up to one year. This means that exercise can be considered as a treatment option without the common side-effects of psychotropic medication.

Exercise helps chronic depression by increasing serotonin (which helps your brain regulate mood, sleep and appetite) or brain-derived neurotrophic factor (which helps neurons to grow) and increases your level of endorphins, which are natural mood lifters.

So exercise therapy could be a vital component of your treatment plan. Talk to your doctor or physical therapist.

Does exercise help you with depression?

Tell us what you think in the comments below.

References:

1.         Daley A. Exercise and Depression: A Review of Reviews. Journal of Clinical Psychology in Medical Settings 2008;15:140.

2.         Hoffman BM BM, Craighead WE, Sherwood A, Doraiswamy PM, Coons MJ, . Exercise and pharmacotherapy in patients with major depression: one-year follow-up of the SMILE study. Psychosomatic Medicine 2011; 73:127–33.

3.         Roeh A, Kirchner SK, Malchow B, et al. Depression in somatic disorders: is there a beneficial effect of exercise? Frontiers in Psychiatry 2019;10.

The nation’s lungs can breathe easier since Australia won a trade dispute against the tobacco industry this week over plain packaging for cigarettes. Backed by the World Health Organisation, international action on tobacco control will have legal muscle, according to an editorial in the Lancet this week.

This follows reports from China last month that trains are to be smoke-free and that in Japan new laws were passed to make smoking in bars and restaurants illegal, paving the way for a tobacco-free 2020 Olympics. Although these wins are a major step forward in global anti-smoking efforts the editorial stated that despite the fall in prevalence since 1990, the actual number of smokers continues to increase worldwide owing to population growth.

While the latest global legal successes are good progress, the editorial pointed out that it will be necessary to intensely monitor the tobacco industry to sustain the progress made so far.

Editorial, Lancet; 392 (10141):1, July 2018

What are your views on smoking? Are we doing enough to reduce harm from tobacco?

Leave your comments below

 

Transcranial magnetic stimulation (TMS), a trialled and tested treatment for major depressive disorder could soon become affordable to the average Australian. An article in the Medical Journal of Australia this week has called for a medicare item number for TMS. This will make it an accessible treatment to those who need it. Currently, private out-patients fork out a prohibitive $6000 for a course of 20–30 TMS treatments delivered over 4–6 weeks. TMS may also become available as a treatment for major depressive disorder to in-patients as part of a private psychiatric clinic admission.

TMS is less invasive than electro convulsive therapy (ECT) and does not require an anaesthetic team and recovery room to conduct the treatment. Like ECT, which is effective in many patients, TMS is recommended for patients with treatment-resistant depression but does not cause memory impairments that some ECT patients experience.

The article says that over the past two decades TMS has been subject to robust testing; 59 sham controlled trials, 30 systematic reviews and meta-analyses as well as naturalistic studies with effective results.

Depression affects at least one in five people during their lifetime. Three-quarters of depressive illnesses start before the age of 24 and half before the age of 18.

An item number for TMS would help all people who need it to access this important therapeutic advance.

Med J Aust 2018; 208 (11): 468. || doi: 10.5694/mja17.00849

Would an item number for TMS make a difference to you?

What do you think of new technologies in mental health treatment?

Please leave  your comments below.