Reliable, neutral, and comprehensive, or their antithesis? A cross-sectional analysis of electroconvulsive therapy-related video quality across TikTok, BiliBili, and YouTube.
Electroconvulsive therapy (ECT) is a well-established and effective treatment for several psychiatric disorders, however, stigma and misinformation surrounding ECT remain widespread. Social media has become a major source of health information for patients and may influence treatment perceptions and decision-making, yet the quality and reliability of ECT-related content vary substantially across platforms. This study aimed to evaluate the quality, reliability, and dissemination characteristics of ECT-related videos on TikTok, BiliBili, and YouTube, and to identify factors associated with higher informational quality.
On December 8, 2025, the top 100 videos retrieved using the Chinese keyword "" on TikTok and BiliBili, and the English term "ECT" on YouTube were screened. Videos were independently assessed for attitude toward ECT, content completeness, and overall quality using the Global Quality Scale (GQS), modified DISCERN (mDISCERN), and the Medical Video Evaluation Tool (MQ-VET). Inter-rater reliability was calculated, and non-parametric statistical tests and Spearman correlation analyses were performed.
A total of 71 TikTok videos, 75 BiliBili videos, and 86 YouTube videos were included. YouTube videos demonstrated significantly greater content completeness than those on BiliBili. Overall quality scores were higher on YouTube than on BiliBili, and YouTube also outperformed TikTok in both mDISCERN and total MQ-VET scores. Video uploader identity, presentation format, and content category were differentially associated with video quality across platforms. Engagement metrics were not correlated with video quality on TikTok or BiliBili, whereas positive correlations were observed on YouTube.
Substantial platform-specific differences exist in the dissemination and quality of ECT-related health information. TikTok demonstrates strong user engagement, whereas YouTube provides more comprehensive and reliable content. These findings underscore the importance of platform-tailored, evidence-based strategies to improve the quality and public communication of ECT-related information.
On December 8, 2025, the top 100 videos retrieved using the Chinese keyword "" on TikTok and BiliBili, and the English term "ECT" on YouTube were screened. Videos were independently assessed for attitude toward ECT, content completeness, and overall quality using the Global Quality Scale (GQS), modified DISCERN (mDISCERN), and the Medical Video Evaluation Tool (MQ-VET). Inter-rater reliability was calculated, and non-parametric statistical tests and Spearman correlation analyses were performed.
A total of 71 TikTok videos, 75 BiliBili videos, and 86 YouTube videos were included. YouTube videos demonstrated significantly greater content completeness than those on BiliBili. Overall quality scores were higher on YouTube than on BiliBili, and YouTube also outperformed TikTok in both mDISCERN and total MQ-VET scores. Video uploader identity, presentation format, and content category were differentially associated with video quality across platforms. Engagement metrics were not correlated with video quality on TikTok or BiliBili, whereas positive correlations were observed on YouTube.
Substantial platform-specific differences exist in the dissemination and quality of ECT-related health information. TikTok demonstrates strong user engagement, whereas YouTube provides more comprehensive and reliable content. These findings underscore the importance of platform-tailored, evidence-based strategies to improve the quality and public communication of ECT-related information.