Remote Psychiatric Evaluations Just As Accurate
> 10/17/2007 3:32:35 PM

We have covered so many studies proving the effectiveness of telepsychiatry that even the most technology-averse critic may have a hard time doubting the potential of this expanding field. Time and again, studies show that a phone-call or email can lessen the severity of a mental illness just as well as a session on a psychiatrist’s couch. However, these studies involved patients who came in with a precise diagnosis, leaving some doubt about whether telepsychiatry can evaluate mental illness as well as treat it. To fill this gap, Dr. Kenneth Kobak published a study on evaluation accuracy in a recent issue of Depression and Anxiety.

Dr. Kobak compared the accuracy of both telephone and videoconference evaluation with face-to-face evaluation. To do this, he focused on the administration of one specific test, the Montgomery-Asberg Depression Rating Scale (MADRS). The MADRS uses eight variables to calculate level of depression, the first of which is “Apparent Sadness”, which the test guidelines suggest should be measured by observing speech, facial expression, and posture. While doctors were unable to observe facial expression and posture over the phone, they were still capable of assigning scores over the phone that differed by less than one point on average from the face-to-face scores (.74 points out of a possible range from 0 to 48). This is more evidence that the versatile human mind can pick up information of equivalent depth when confined to fewer senses; when only voice is available for scrutiny, all available attention is brought to bear on that one stimulus. The scores for videoconference evaluation differered from face-to-face by only .5 points, a gap that could be easily closed as patient and doctor become more familiar with the technology.

Telepsychiatry studies are finally able to show that remote therapy can be as effective as in-person therapy in every step of the process. From initial evaluation to symptom management to progress monitoring, telepsychiatry achieves results equal to traditional methods, and it does so at lower cost. For many who seek mental health treatment, the traditional brick and mortar settings will always be the option of choice. But for many individuals without a choice, and for other who may not be comfortable leaving their apartment or traveling to a doctor's office, telepsychiatry continues to prove a powerful tool. While many doctors and patients who do try these new options, will continue to feel more comfortable having at least an initial meeting in-person, even this small vestige of traditional therapy may not be strictly necessary.

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