Mental health-related conversations on social media and crisis episodes: a time-series regression analysis
Authors: David Chandran
Kalina Bontcheva
David P J Osborn
Ioannis Bakolis
Anna Kolliakou
Robert Stewart
Nomi Werbeloff
Leon Derczynski
Journal: Scientific Reports (2020)
Discipline: Multidisciplinary
Keywords: Twitter posts; mental health crisis episodes; depression; schizophrenia; temporal trends
Affiliations: Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom. ., Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom., Centre for Implementation Science, Health Services and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom., Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom., Department of Computer Science, IT University of Copenhagen, Copenhagen, Denmark., Division of Psychiatry, University College London, London, United Kingdom., Camden and Islington NHS Foundation Trust, London, United Kingdom., Department of Computer Science, University of Sheffield, Sheffield, United Kingdom., South London and Maudsley NHS Foundation Trust, London, United Kingdom.

Abstract:  We aimed to investigate whether daily fluctuations in mental health-relevant Twitter posts are associated with daily fluctuations in mental health crisis episodes. We conducted a primary and replicated time-series analysis of retrospectively collected data from Twitter and two London mental healthcare providers. Daily numbers of 'crisis episodes' were defined as incident inpatient, home treatment team and crisis house referrals between 2010 and 2014. Higher volumes of depression and schizophrenia tweets were associated with higher numbers of same-day crisis episodes for both sites. After adjusting for temporal trends, seven-day lagged analyses showed significant positive associations on day 1, changing to negative associations by day 4 and reverting to positive associations by day 7. There was a 15% increase in crisis episodes on days with above-median schizophrenia-related Twitter posts. A temporal association was thus found between Twitter-wide mental health-related social media content and crisis episodes in mental healthcare replicated across two services. Seven-day associations are consistent with both precipitating and longer-term risk associations. Sizes of effects were large enough to have potential local and national relevance and further research is needed to evaluate how services might better anticipate times of higher risk and identify the most vulnerable groups. 

Retracted: No

PubPeer comments:
 This is an entertaining paper, but its connection to the  Global Dermatology theme of this Special Issue of the journal is unclear. It appears to be an attempt to legitimise various forms of quackery, including  low-dose medicine , which is homeopathy - given a new sciency name to make it sound less like medieval superstition.  The Bioregulatory System Medicine (BrSM), the subsequent evolution of Systems Medicine, aims to bridge this gap through the use of **low dose medicines** with precise, targeted and synergistic bioregulatory capacities. A few pages later, we read that  the medicinal product Lymphomyosot, originally developed for lymphatic pathology, has subsequently shown that it can also be usefully used for wound healing .  Lymphomyosot is [a homeopathic product] , purportedly made using Equisetum but containing no active ingredient. The authors also note that the **acupuncture** modality of med-fraud is another intrinsic element of their  BrSM quackery:  In fact, injection into the acupuncture points is frequent in the BrSM approach . Then there s this:  In numerous publications, it is argued that connective tissue is an organ with interconnecting properties[71], [72]. A recent publication in **Nature** even speaks of interstitial spaces containing fluidly plastic structures previously not characterised, emphasising the fundamental function of this important tissue and introducing for it the most correct classification of the organ [73]. Ref [73] is to a widely-derided press release in Scientific Reports - not the same as **Nature**, whatever the authors believe! - in which [a New Age self-promoter claimed originality for his rediscovery of the fascia] , and attempted to rebrand it as the interstitium . Ref [71] is by Langevin, [another quackupuncture enthusiast] , and published in Medical Hypotheses . The authors do not seem to have used the word  quantum . I must deduct 5 points for this omission. ,