Diurnal Variations of Depression-Related Health Information Seeking: Case Study in Finland Using Google Trends Data

Background: Some of the temporal variations and clock-like rhythms that govern several different health-related behaviors can be traced in near real-time with the help of search engine data. This is especially useful when studying phenomena where little or no traditional data exist. One specific area where traditional data are incomplete is the study of diurnal mood variations, or daily changes in individuals' overall mood state in relation to depression-like symptoms. Objective: The objective of this exploratory study was to analyze diurnal variations for interest in depression on the Web to discover hourly patterns of depression interest and help seeking. Methods: Hourly query volume data for 6 depression-related queries in Finland were downloaded from Google Trends in March 2017. A continuous wavelet transform (CWT) was applied to the hourly data to focus on the diurnal variation. Longer term trends and noise were also eliminated from the data to extract the diurnal variation for each query term. An analysis of variance was conducted to determine the statistical differences between the distributions of each hour. Data were also trichotomized and analyzed in 3 time blocks to make comparisons between different time periods during the day. Results: Search volumes for all depression-related query terms showed a unimodal regular pattern during the 24 hours of the day. All queries feature clear peaks during the nighttime hours around 11 PM to 4 AM and troughs between 5 AM and 10 PM. In the means of the CWT-reconstructed data, the differences in nighttime and daytime interest are evident, with a difference of 37.3 percentage points (pp) for the term "Depression," 33.5 pp for "Masennustesti," 30.6 pp for "Masennus," 12.8 pp for "Depression test," 12.0 pp for "Masennus testi," and 11.8 pp for "Masennus oireet." The trichotomization showed peaks in the first time block (00.00 AM-7.59 AM) for all 6 terms. The search volumes then decreased significantly during the second time block (8.00 AM-3.59 PM) for the terms "Masennus oireet" (P<.001), "Masennus" (P=.001), "Depression" (P=.005), and "Depression test" (P=.004). Higher search volumes for the terms "Masennus" (P=.14), "Masennustesti" (P=.07), and "Depression test" (P=.10) were present between the second and third time blocks. Conclusions: Help seeking for depression has clear diurnal patterns, with significant rise in depression-related query volumes toward the evening and night. Thus, search engine query data support the notion of the evening-worse pattern in diurnal mood variation. Information on the timely nature of depression-related interest on an hourly level could improve the chances for early intervention, which is beneficial for positive health outcomes.