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      Is Google Trends a useful tool for tracking mental and social distress during a public health emergency? A time–series analysis

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          Highlights

          • •

            Google search data are increasingly used to assess trends in population mental health

          • •

            Few studies have assessed the validity of this approach

          • •

            Search trends did not follow changes in measured mental health during the COVID-19 pandemic

          • •

            Google searches and self-reported loneliness were associated

          Abstract

          Background

          Google Trends data are increasingly used by researchers as an indicator of population mental health, but few studies have investigated the validity of this approach during a public health emergency.

          Methods

          Relative search volumes (RSV) for the topics depression, anxiety, self-harm, suicide, suicidal ideation, loneliness, and abuse were obtained from Google Trends. We used graphical and time-series approaches to compare daily trends in searches for these topics against population measures of these outcomes recorded using validated self-report scales (PHQ-9; GAD-7; UCLA-3) in a weekly survey (n = ~70,000) of the impact COVID-19 on psychological and social experiences in the UK population (21/03/2020 to 21/08/ 2020).

          Results

          Self-reported levels of depression, anxiety, self-harm/suicidal ideation, self-harm, loneliness and abuse decreased during the period studied. There was no evidence of an association between self-reported anxiety, self-harm, abuse and RSV on Google Trends. Trends in Google topic RSV for depression and suicidal ideation were inversely associated with self-reports of these outcomes ( p = 0.03 and p = 0.04, respectively). However, there was statistical and graphical evidence that self-report and Google searches for loneliness ( p < 0.001) tracked one another.

          Limitations

          No age/sex breakdown of Google Trends data available. Survey respondents were not representative of the UK population and no pre-pandemic data were available.

          Conclusion

          Google Trends data do not appear to be a useful indicator of changing levels of population mental health during a public health emergency, but may have some value as an indicator of loneliness.

          Graphical abstract

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          Most cited references35

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          A brief measure for assessing generalized anxiety disorder: the GAD-7.

          Robert L Spitzer, Kurt Kroenke, Janet B W Williams … (2006)
          Generalized anxiety disorder (GAD) is one of the most common mental disorders; however, there is no brief clinical measure for assessing GAD. The objective of this study was to develop a brief self-report scale to identify probable cases of GAD and evaluate its reliability and validity. A criterion-standard study was performed in 15 primary care clinics in the United States from November 2004 through June 2005. Of a total of 2740 adult patients completing a study questionnaire, 965 patients had a telephone interview with a mental health professional within 1 week. For criterion and construct validity, GAD self-report scale diagnoses were compared with independent diagnoses made by mental health professionals; functional status measures; disability days; and health care use. A 7-item anxiety scale (GAD-7) had good reliability, as well as criterion, construct, factorial, and procedural validity. A cut point was identified that optimized sensitivity (89%) and specificity (82%). Increasing scores on the scale were strongly associated with multiple domains of functional impairment (all 6 Medical Outcomes Study Short-Form General Health Survey scales and disability days). Although GAD and depression symptoms frequently co-occurred, factor analysis confirmed them as distinct dimensions. Moreover, GAD and depression symptoms had differing but independent effects on functional impairment and disability. There was good agreement between self-report and interviewer-administered versions of the scale. The GAD-7 is a valid and efficient tool for screening for GAD and assessing its severity in clinical practice and research.
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            The PHQ-9: validity of a brief depression severity measure.

            K Kroenke, R L Spitzer, J. Williams (2001)
            While considerable attention has focused on improving the detection of depression, assessment of severity is also important in guiding treatment decisions. Therefore, we examined the validity of a brief, new measure of depression severity. The Patient Health Questionnaire (PHQ) is a self-administered version of the PRIME-MD diagnostic instrument for common mental disorders. The PHQ-9 is the depression module, which scores each of the 9 DSM-IV criteria as "0" (not at all) to "3" (nearly every day). The PHQ-9 was completed by 6,000 patients in 8 primary care clinics and 7 obstetrics-gynecology clinics. Construct validity was assessed using the 20-item Short-Form General Health Survey, self-reported sick days and clinic visits, and symptom-related difficulty. Criterion validity was assessed against an independent structured mental health professional (MHP) interview in a sample of 580 patients. As PHQ-9 depression severity increased, there was a substantial decrease in functional status on all 6 SF-20 subscales. Also, symptom-related difficulty, sick days, and health care utilization increased. Using the MHP reinterview as the criterion standard, a PHQ-9 score > or =10 had a sensitivity of 88% and a specificity of 88% for major depression. PHQ-9 scores of 5, 10, 15, and 20 represented mild, moderate, moderately severe, and severe depression, respectively. Results were similar in the primary care and obstetrics-gynecology samples. In addition to making criteria-based diagnoses of depressive disorders, the PHQ-9 is also a reliable and valid measure of depression severity. These characteristics plus its brevity make the PHQ-9 a useful clinical and research tool.
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              The PHQ-9

              Kurt Kroenke, Robert L Spitzer, Janet B W Williams (2001)
              Article 0 comments Cited 2826 times – based on 0 reviews     Review now
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                Author and article information

                Contributors
                David Gunnell
                Journal
                Journal ID (nlm-ta): J Affect Disord
                Journal ID (iso-abbrev): J Affect Disord
                Title: Journal of Affective Disorders
                Publisher: Elsevier/North-Holland Biomedical Press
                ISSN (Print): 0165-0327
                ISSN (Electronic): 1573-2517
                Publication date PMC-release: 01 November 2021
                Publication date (Print): 01 November 2021
                Volume: 294
                Pages: 737-744
                Affiliations
                [a ]Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.
                [b ]National Institute of Health Research Biomedical Research Centre, University Hospitals Bristol and Weston NHS Foundation Trust, UK
                [c ]Population Data Science, Swansea University Medical School, Swansea, UK
                [d ]Department of Behavioural Science and Health, University College London, London, UK
                Author notes
                [* ]Corresponding author. d.j.gunnell@ 123456bristol.ac.uk
                [1]

                These authors have equally contributed to this work

                Article
                Publisher Item ID: S0165-0327(21)00674-1
                DOI: 10.1016/j.jad.2021.06.086
                PMC ID: 8411666
                PubMed ID: 34348169
                SO-VID: 5b113574-f9e5-4e43-a3cc-60b246b98259
                Copyright © © 2021 The Authors. Published by Elsevier B.V.
                License:

                This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).

                History
                Date received : 17 February 2021
                Date revision received : 26 June 2021
                Date accepted : 30 June 2021
                Categories
                Subject: Research Paper

                ScienceOpen disciplines: Clinical Psychology & Psychiatry
                Keywords: mental health,pandemic,suicide,depression,loneliness,anxiety,domestic violence
                Data availability:
                ScienceOpen disciplines: Clinical Psychology & Psychiatry
                Keywords: mental health, pandemic, suicide, depression, loneliness, anxiety, domestic violence

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