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SAN FRANCISCO -- Mental healthcare providers may want to consider stepping up their TikTok game, according to an analysis of social media-based information on dissociative identity disorder (DID), a rare psychiatric disorder where individuals have two or more separate identities.

In a review of 97 TikToks featuring DID information, just 5.2% were considered useful, 10.3% were misleading, and 84.5% were neither useful or misleading, reported medical student Isreal Bladimir Munoz, of the University of Texas Medical Branch in Galveston, at the American Psychiatric Association (APA) annual meeting.

However, in a review of 60 YouTube videos featuring DID information, 51.7% were useful, 6.7% were misleading, and 41.7% were neither, Munoz said during a press briefing.

While DID affects fewer than 1% of the general population, its popularity as a subject has grown on social media platforms. This trend allows for some meaningful education about the disorder, according to the researchers, but they cautioned that social media poses a danger of spreading misinformation about the condition as well.

"Based on our study, we recommend that healthcare professionals should create more educational videos and interviews on TikTok, focusing on creating more accurate information about DID," Munoz told 番茄社区app. "We need to understand how social media algorithms work, as this is essential for healthcare professionals who are aiming to disseminate medically accurate information and engage with a wider audience."

Munoz noted that these platforms use intricate algorithms that prioritize content that is engaging and preferred by users, so healthcare professionals should try to understand these systems better to help them create highly accurate content that reaches large audiences. He added that proven strategies for accomplishing this goal include posting timely and reliable information, using appropriate medical hashtags, creating visually interesting videos, and actively interacting with their online community.

"Teenagers are always on social media, we know this already," said APA session moderator Howard Liu, MD, of the University of Nebraska Medical Center in Omaha. "It's probably their first line of information."

Social media represents an opportunity for promoting healthcare literacy, he suggested, adding that the content needs to be both accurate and compelling.

"If you think about disseminating accurate health information to different communities, we want to make sure that we don't shy away from some of these platforms," said Liu, who is also chair of the APA Council on Communications.

To conduct the analysis, the researchers searched YouTube and TikTok using specific search phrases, including dissociative identity disorder, multiple personality disorder, and split personality disorder. They then sorted videos by the "most viewed" for YouTube and the "most liked" for TikTok, and selected the top videos from each platform for analysis.

They excluded videos that were either unrelated to DID, under 1 minute in length on YouTube, or not in English. They also excluded videos without audio and any duplicates.

The videos were then evaluated by four independent reviewers who classified each video as useful, misleading, or neither. The reviewers also analyzed the videos using the Global Quality Scale () and modified DISCERN scale (). GQS scores range from 1 (poor quality and not useful to patients) to 5 (excellent quality and very useful), while mDISCERN has a potential total score of 5 points, with higher scores indicating higher reliability.

The researchers reported that there was a significant difference seen between mDISCERN and GQS score and the video source, type of content, and classification. For instance, for YouTube video source, educational organizations and health professionals had the two highest scores, while independent users and film/TV had the two lowest. For TikTok video source, organizations had the highest scores, while podcasts and film/TV had the two lowest. Educational videos scored highest on both platforms while comedy skits scored much lower.

"Our study highlighted the importance of critically evaluating the quality and accuracy of medical information on social media platforms, particularly regarding DID," Munoz said. "By aligning their content with social media algorithms, healthcare professionals can contribute to the dissemination of trustworthy health information in this new digital realm."

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