Psychiatry on Twitter: Content Analysis of the Use of Psychiatric Terms in French
Authors: Delanys Sarah , Benamara Farah , Moriceau Véronique , Olivier François , Mothe Josiane 
Published: June 2020

Background
With the advent of digital technology and specifically user-generated contents in social media, new ways emerged for studying possible stigma of people in relation with mental health. Several pieces of work studied the discourse conveyed about psychiatric pathologies on Twitter considering mostly tweets in English and a limited number of psychiatric disorders terms. This paper proposes the first study to analyze the use of a wide range of psychiatric terms in tweets in French.

Objective
Our aim is to study how generic, nosographic, and therapeutic psychiatric terms are used on Twitter in French. More specifically, our study has 3 complementary goals: (1) to analyze the types of psychiatric word use (medical, misuse, or irrelevant), (2) to analyze the polarity conveyed in the tweets that use these terms (positive, negative, or neural), and (3) to compare the frequency of these terms to those observed in related work (mainly in English).

Methods
Our study was conducted on a corpus of tweets in French posted from January 1, 2016, to December 31, 2018, and collected using dedicated keywords. The corpus was manually annotated by clinical psychiatrists following a multilayer annotation scheme that includes the type of word use and the opinion orientation of the tweet. A qualitative analysis was performed to measure the reliability of the produced manual annotation, and then a quantitative analysis was performed considering mainly term frequency in each layer and exploring the interactions between them.

Results
One of the first results is a resource as an annotated dataset. The initial dataset is composed of 22,579 tweets in French containing at least one of the selected psychiatric terms. From this set, experts in psychiatry randomly annotated 3040 tweets that corresponded to the resource resulting from our work. The second result is the analysis of the annotations showing that terms are misused in 45.33% (1378/3040) of the tweets and that their associated polarity is negative in 86.21% (1188/1378) of the cases. When considering the 3 types of term use, 52.14% (1585/3040) of the tweets are associated with a negative polarity. Misused terms related to psychotic disorders (721/1300, 55.46%) were more frequent to those related to depression (15/280, 5.4%).

Conclusions
Some psychiatric terms are misused in the corpora we studied, which is consistent with the results reported in related work in other languages. Thanks to the great diversity of studied terms, this work highlighted a disparity in the representations and ways of using psychiatric terms. Moreover, our study is important to help psychiatrists to be aware of the term use in new communication media such as social networks that are widely used. This study has the huge advantage to be reproducible thanks to the framework and guidelines we produced so that the study could be renewed in order to analyze the evolution of term usage. While the newly build dataset is a valuable resource for other analytical studies, it could also serve to train machine learning algorithms to automatically identify stigma in social media.