Areas of Interest and Social Consideration of Antidepressants on English Tweets: A Natural Language Processing Classification Study

Abstract

Background: Antidepressants are the foundation of the treatment of major depressive disorders. Despite the scientific evidence, there is still a sustained debate and concern about the efficacy of antidepressants, with widely differing opinions among the population about their positive and negative effects, which may condition people’s attitudes towards such treatments. Our aim is to investigate Twitter posts about antidepressants in order to have a better understanding of the social consideration of antidepressants. Methods: We gathered public tweets mentioning antidepressants written in English, published throughout a 22-month period, between 1 January 2019 and 31 October 2020. We analysed the content of each tweet, determining in the first place whether they included medical aspects or not. Those with medical content were classified into four categories: general aspects, such as quality of life or mood, sleep-related conditions, appetite/weight issues and aspects around somatic alterations. In non-medical tweets, we distinguished three categories: commercial nature (including all economic activity, drug promotion, education or outreach), help request/offer, and drug trivialization. In addition, users were arranged into three categories according to their nature: patients and relatives, caregivers, and interactions between Twitter users. Finally, we identified the most mentioned antidepressants, including the number of retweets and likes, which allowed us to measure the impact among Twitter users. Results: The activity in Twitter concerning antidepressants is mainly focused on the effects these drugs may have on certain health-related areas, specifically sleep (20.87%) and appetite/weight (8.95%). Patients and relatives are the type of user that most frequently posts tweets with medical content (65.2%, specifically 80% when referencing sleep and 78.6% in the case of appetite/weight), whereas they are responsible for only 2.9% of tweets with non-medical content. Among tweets classified as non-medical in this study, the most common subject was drug trivialization (66.86%). Caregivers barely have any presence in conversations in Twitter about antidepressants (3.5%). However, their tweets rose more interest among other users, with a ratio 11.93 times higher than those posted by patients and their friends and family. Mirtazapine is the most mentioned antidepressant in Twitter (45.43%), with a significant difference with the rest, agomelatine (11.11%). Conclusions: This study shows that Twitter users that take antidepressants, or their friends and family, use social media to share medical information about antidepressants. However, other users that do not talk about antidepressants from a personal or close experience, frequently do so in a stigmatizing manner, by trivializing them. Our study also brings to light the scarce presence of caregivers in Twitter.

Assessment of beliefs and attitudes about electroconvulsive therapy posted on Twitter: An observational study

“…When discussing this study in the context of previous research on mental health topics on Twitter, it is noted that the total amount of retrieved publications for ECT is lower than the amount of retrieved tweets in other studies related to other treatments for mental disorders including antipsychotics, antidepressants, and medications for attention-deficit/hyperactivity disorder [ 27 , 28 , 34 ]. They are even lower in amount than tweets for nonpsychiatric disorders, such as statins, medications for obesity, chemotherapy agents, or antibiotics [ 24 , 34 – 36 ]. Such differences seem coherent with the lower prevalence of ECT use as compared to those other treatments.…”

“…The aforementioned previous Twitter research related to psychopharmacological drugs also described the types of users involved in discussions related to such treatments [ 28 , 34 ]. For antidepressants and antipsychotics, people with lived experience and their relatives were authors of more than half the tweets, which contrasts with the lower relative proportions of tweets from such users in ECT tweets in our study.…”

“…Another study in the same year compared trivialization between mental disorders and physical health conditions, demonstrating that such contents were 2.10 higher in the former [ 47 ]. Our research team has analyzed in the past stigmatizing attitudes regarding psychopharmacological treatments finding notable proportions of such contents, which resemble proportions found for discussions on mental disorders [ 28 , 34 ]. This leads us to think that stigmatization of mental disorders extends to psychopharmacological treatments [ 50 ], and it is remarkable that such stigma seems much higher for ECT, being present in more than half of their tweets of our current sample.…”

Antidepressants: A content analysis of healthcare providers' tweets

“…37 The accessibility and global presence make it a notable social media platform for healthcare providers to exert influence on the general public through tweets, as well as for scientific researchers to extract opinions from a certain population. 28 , 29 , 38 A previous study on general attitudes to antidepressants on Twitter found a low proportion of healthcare providers' referring to and discussing this. 29 However, studies specifically exploring and reporting on healthcare providers' engagement are absent.…”

“… 18 , 19 , 20 , 24 , 25 , 26 , 27 Additionally, avoiding the tension of a face-to-face consultation with a physician wearing a white coat, an informal online setting may encourage the public to explore and express their feelings more genuinely and objectively. 28 , 29 Overall, considering the emergence of mobile internet and that social media users account for nearly 60 % of the global population, social media has become a prominent source of public voices and communication. 26 , 30…”