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Cited by 43Mental Health via WritingSuicide and Self-Harm StudiesImpact of Technology on Adolescents

Monitoring Online Discussions About Suicide Among Twitter Users With Schizophrenia: Exploratory Study

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Hswen, Yulin, Naslund, John A, Brownstein, John S, Hawkins, Jared B·2018·JMIR Mental Health
DOI 10.2196/11483PMC PMC6315229

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Abstract

Background: People with schizophrenia experience elevated risk of suicide. Mental health symptoms, including depression and anxiety, contribute to increased risk of suicide. Digital technology could support efforts to detect suicide risk and inform suicide prevention efforts. Objective: This exploratory study examined the feasibility of monitoring online discussions about suicide among Twitter users who self-identify as having schizophrenia. Methods: Posts containing the terms suicide or suicidal were collected from a sample of Twitter users who self-identify as having schizophrenia (N=203) and a random sample of control users (N=173) over a 200-day period. Frequency and timing of posts about suicide were compared between groups. The associations between posting about suicide and common mental health symptoms were examined. Results: Twitter users who self-identify as having schizophrenia posted more tweets about suicide (mean 7.10, SD 15.98) compared to control users (mean 1.89, SD 4.79; t374=-4.13, P<.001). Twitter users who self-identify as having schizophrenia showed greater odds of tweeting about suicide compared to control users (odds ratio 2.15, 95% CI 1.42-3.28). Among all users, tweets about suicide were associated with tweets about depression (r=0.62, P<.001) and anxiety (r=0.45, P<.001). Conclusions: Twitter users who self-identify as having schizophrenia appear to commonly discuss suicide on social media, which is associated with greater discussion about other mental health symptoms. These findings should be interpreted cautiously, as it is not possible to determine whether online discussions about suicide correlate with suicide risk. However, these patterns of online discussion may be indicative of elevated risk of suicide observed in this patient group. There may be opportunities to leverage social media for supporting suicide prevention among individuals with schizophrenia.

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  • Twitter users with a self-disclosed diagnosis of schizophrenia more frequently discuss suicide.

    “Several studies have also demonstrated that when compared to a control group, Twitter users with a self-disclosed diagnosis of schizophrenia show unique online communication patterns (Michael L Birnbaum, Ernala, Rizvi, De Choudhury, & Kane, 2017), including more frequent discussion of tobacco use (Hswen et al., 2017), symptoms of depression and anxiety (Hswen, Naslund, Brownstein, & Hawkins, 2018b”

    From Social Media and Mental Health: Benefits, Risks, and Opportunities for Research and Practice (2020) · cites this paper as Hswen, Naslund, Brownstein, & Hawkins, 2018a

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Cited by

Sorted by citations

Authors
Hswen, Y., Naslund, J. A., Brownstein, J. S., & Hawkins, J. B.
Affiliations
  • Boston Children's Hospital (US)
  • Harvard University (US)
Corresponding author
Hswen, Yulin
ORCID
Venue
JMIR Mental Health
Publisher
JMIR Publications Inc.
Published
2018-12-13
Volume
5
Issue
4
Pages
e11483
ISSN
2368-7959 (ISSN-L)
DOI
10.2196/11483
PMC
PMC6315229
OpenAlex
W2904036830
Cited by
43
References
11
Citations by year
2025: 2 · 2024: 6 · 2023: 4 · 2022: 8 · 2021: 10 · 2020: 10 · 2019: 2 · 2018: 1
FWCI
7.79
Type
journal article
Language
en
Open access
Licence
cc-by
Locations
  • JMIR Mental Health (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
Funders
  • Robert Wood Johnson Foundation (73495)
  • National Institutes of Health (5u19mh113211-05)
  • Canadian Institutes of Health Research
  • National Institute of Mental Health (U19 MH-113211, 5U19MH113211)
  • National Human Genome Research Institute (U54HG007963)
Topics
  • Social Sciences › Psychology › Social Psychology › Mental Health via Writing
  • Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
  • Social Sciences › Sociology and Political Science › Impact of Technology on Adolescents
Keywords
schizophrenia, suicide, Twitter, social media, suicide risk, depression, anxiety, suicide prevention

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