Skip to main content Accessibility help
×
Home
Hostname: page-component-99c86f546-x5mqb Total loading time: 0.343 Render date: 2021-11-30T07:34:26.253Z Has data issue: true Feature Flags: { "shouldUseShareProductTool": true, "shouldUseHypothesis": true, "isUnsiloEnabled": true, "metricsAbstractViews": false, "figures": true, "newCiteModal": false, "newCitedByModal": true, "newEcommerce": true, "newUsageEvents": true }

Can Telepsychiatry Replace In-Person Psychiatric Assessments? A Review and Meta-Analysis of Comparison Studies

Published online by Cambridge University Press:  07 November 2014

Abstract

Objective: The authors conducted a review and meta-analysis of the literature comparing telepsychiatry with “in-person” psychiatric assessments.

Method: Approximately 380 studies on telepsychiatry published between 1956 and 2002 were identified using MEDLINE, PsycINFO, and cross-referenced bibliographies. Of these, 14 studies with an N>10 compared telepsychiatry with in-person psychiatry (I-P) using objective assessment instruments or satisfaction instruments. Three of these studies compared high bandwidth (HB) with low bandwidth (LB) telepsychiatry.

Results: Fourteen studies of 500 patients met inclusion criteria and were included in the meta-analysis. Telepsychiatry was found to be similar to I-P for the studies using objective assessments. Effect sizes were on average quite small, suggesting no difference between telepsychiatry and I-P. Bandwidth was found to be a significant moderator. Three moderators were tested, effect sizes remained largely heterogeneous, and further analyses are needed to determine the direction of effect. There was no difference between I-P and telepsychiatry between the HB and LB groups, although there are anecdotal data suggesting that H B was slightly superior for assessments requiring detailed observation of subjects.

Conclusion: Out of a large telepsychiatry literature published over the past 40+ years, only a handful of studies have attempted to compare telepsychiatry with I-P directly using standardized assessment instruments that permit meaningful comparisons. However, in those studies, the current meta-analysis concludes there is no difference in accuracy or satisfaction between the two modalities. Over the next few years, we expect telepsychiatry to replace I-P in certain research and clinical situations.

Type
Research Article
Copyright
Copyright © Cambridge University Press 2005

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Bashshur, RL. Telemedicine Explorations in the Use of Telecommunications in Health Care. Springfield Ill: Charles Thomas; 1975:5488.Google Scholar
2.Preston, J, Brown, FW, Hartley, B. Using telemedicine to improve health care in distant areas. Hosp Community Psychiatry. 1992;43:2532.Google ScholarPubMed
3.Kavanagh, SJ, Yellowlees, PM. Telemedicine—clinical applications in mental health. Aust Fam Physician. 1995;24:12421247.Google Scholar
4.Yellowlees, PM, Kennedy, C. Telemedicine applications in an integrated mental health service based at a teaching hospital. J Telemed Telecare. 1996;2:205209.CrossRefGoogle Scholar
5.Zarate, CA Jr, Weinstock, L, Cukor, P, et al. Applicability of telemedicine for assessing patients with schizophrenia: acceptance and reliability. J Clin Psychiatry. 1997;58:2225.CrossRefGoogle ScholarPubMed
6.Hailey, D, Jacobs, P, Simpson, J, Doze, S. An assessment framework for telemedicine applications. J Telemed Telecare. 1999;5:162170.CrossRefGoogle ScholarPubMed
7.Roine, R, Ohinmaa, A, Hailey, D. Assessing telemedicine: a systematic review of the literature. CMAJ. 2001;165:765771.Google ScholarPubMed
8.Field, MJ, ed. Telemedicine: A Guide to Assessing Telecommunications in Healthcare. Washington, DC: National Academic Press; 1996.Google Scholar
9.Bashshur, RL, Sanders, JH, Shannon, GW. Telemedicine: Theory and Practice. Charles Springfield Ill: Charles Thomas; 1997.Google Scholar
10.Yoshino, A, Shigemura, J, Kobayashi, Y, et al. Telepsychiatry: assessment of televideo psychiatric interview reliability with present- and next-generation internet infrastructures. Acta Psychiatr Scand. 2001;104:223226.CrossRefGoogle ScholarPubMed
11.Gelber, H, Alexander, M. An evaluation of an Australian videoconferencing project for child and adolescent telepsychiatry. J Telemed Telecare. 1999;5(suppl 1):S21S23.CrossRefGoogle ScholarPubMed
12.Mielonen, ML, Ohinmaa, A, Moring, J, Isohanni, M. The use of videoconferencing for telepsychiatry in Finland. J Telemed Telecare. 1998;4:125131.CrossRefGoogle ScholarPubMed
13.Haslam, R, McLaren, P. Interactive television for an urban adult mental health service: the Guy's Psychiatric Intensive Care Unit Telepsychiatry Project. J Telemed Telecare. 2000;6(suppl 1):S50S52.CrossRefGoogle ScholarPubMed
14.McLaren, PM, Ball, CJ, Summerfield, AB, Watson, JP, Lipsedge, M. An evaluation of the use of interactive television in an acute psychiatric service. J Telemed Telecare. 1995;1:7985.CrossRefGoogle Scholar
15.Dwyer, TF. Telepsychiatry: psychiatric consultation by interactive television. Am J Psychiatry. 1973;130:865869.CrossRefGoogle ScholarPubMed
16.May, C, Gask, L, Atkinson, T, et al. Telepsychiatry evaluation in the north-west of England: preliminary results of a qualitative study. J Telemed Telecare. 2000;6(suppl 1):S20S22CrossRefGoogle ScholarPubMed
17.Hill, JV, Allman, LR, Ditzler, TE. Utility of real-time video teleconferencing in conducting family mental health sessions: two case reports. Telemed J E Health. 2001;7:5559.CrossRefGoogle ScholarPubMed
18.Bitterman, JE, Schappert, J, Schaefer, J. Overcoming remoteness in CME videoteleconferencing: “I want my MD TV.” J Contin Educ Health Prof. 2000;20:712.CrossRefGoogle Scholar
19.Tucker, WM, Segal, G, Hyler, SE. Psychiatric telemedicine for rural New York. J Psychiatr Pract. 2001;7:279281.CrossRefGoogle ScholarPubMed
20.Craig, K, Yellowlees, P. A community-based approach to evaluation of health outcomes and costs for telepsychiatry in a rural population: preliminary results. J Telemed Telecare. 2000;6(suppl 1):155157.Google Scholar
21.Ermer, D. Experience with a rural telepsychiatry clinic for children and adolescents. Psychiatr Serv. 1999;50:260261.CrossRefGoogle ScholarPubMed
22.Mannion, L, Fahy, TJ, Duffy, C, Broderick, M, Gethins, E. Telepsychiatry: an island project. J Telemed Telecare. 1998;4(suppl 1):6263.CrossRefGoogle ScholarPubMed
23.Meltzer, B. Telemedicine in emergency psychiatry. Psychiatr Serv. 1997;48:11411142.Google ScholarPubMed
24.Graham, AM. Telepsychiatry in Appalachia. Am Behav Sci. 1996;39:602615.CrossRefGoogle Scholar
25.Allen, A, Wheeler, T. Telepsychiatry background and activity survey. The development of telepsychiatry. Telemed Today. 1998;6:3437.Google ScholarPubMed
26.Blackmon, LA, Kaak, HO, Ranseen, J. Consumer satisfaction with telemedicine child psychiatry consultation in rural Kentucky. Psychiatr Serv. 1997;48:14641466.Google ScholarPubMed
27.Brown, F. A survey of telepsychiatry in USA. J Telemed Telecare. 1995;1:1921.CrossRefGoogle ScholarPubMed
28.Baer, L, Elford, L, Cukor, P. Telepsychiatry at forty; what have we learned? Harv Rev Psychiatry. 1997;5:717.CrossRefGoogle ScholarPubMed
29.Frueh, BC, Deitsch, SE, Santos, AB, et al. Procedural and methodological issues in telepsychiatry research and program development. Psychiatr Serv. 2000;51:15221527.CrossRefGoogle ScholarPubMed
30.Tang, WK, Chiu, H, Woo, J, Hjelm, M, Hiu, E. Telepsychiatry in psychogeriatric service: a pilot study. Int J Geriatr Psychiatry. 2001;16:8893.3.0.CO;2-W>CrossRefGoogle ScholarPubMed
31.Simpson, J, Doze, S, Urness, D, Hailey, D, Jacobs, P. Evaluation of a routine telepsychiatry service. J Telemed Telecare. 2001;7:9098.CrossRefGoogle ScholarPubMed
32.Buist, A, Coman, G, Silvas, A, Burrows, G. An evaluation of the telepsychiatry programme in Victoria, Australia. J Telemed Telecare. 2000;6:216221.CrossRefGoogle ScholarPubMed
33.Dossetor, DR, Nunn, KP, Fairley, M, Eggleton, D. A child and adolescent psychiatric outreach service for rural New South Wales: a telemedicine pilot study. J Paediatr Child Health. 1999;35:525529.CrossRefGoogle ScholarPubMed
34.Elford, R. Telemedicine activities at Memorial University of Newfoundland: a historical review, 1975-1997. Telemed J. 1998;4:207224.CrossRefGoogle Scholar
35.Johnston, D, Jones, BN 3rd. Telepsychiatry consultation to a rural nursing facility: a 2-year experience. J Geriatr Psychiatry Neurol. 2001;14:7275.CrossRefGoogle ScholarPubMed
36.Stevens, A, Doidge, N, Goldbloom, D, Voore, P, Farewell, J. Pilot study of televideo psychiatric assessments in an underserviced community. Am J Psychiatry. 1999;156:783785Google Scholar
37.Brown, FW. Rural telepsychiatry. Psychiatr Serv. 1998;49:963964.CrossRefGoogle ScholarPubMed
38.Brodey, BB, Claypoole, KH, Motto, J, Arias, RG, Goss, R. Satisfaction of forensic psychiatric patients with remote telepsychiatric evaluation. Psychiatr Serv. 2000;51:13051307.CrossRefGoogle ScholarPubMed
39.Zaylor, C, Whitten, P, Kingsley, C. Telemedicine services to a county jail. J Telemed Telecare 2000;6(suppl 1):9395.CrossRefGoogle ScholarPubMed
40.Darkins, A. Program management of telemental health care services. J Geriatr Psychiatry Neurol. 2001;14:8087.CrossRefGoogle ScholarPubMed
41.Whitten, P, Kingsley, C, Grigsby, J. Results of a meta-analysis of cost-benefit research: is this a question worth asking? J Telemed Telecare. 2000;6(suppl 1):46.CrossRefGoogle ScholarPubMed
42.Trott, P, Blignault, I. Cost evaluation of a telepsychiatry service in northern Queensland. J Telemed Telecare. 1998;4(suppl 1):6668.CrossRefGoogle ScholarPubMed
43.Paul, NL. Telepsychiatry, the satellite system, and family consultation. J Telemed Telecare. 1997;3:5253.CrossRefGoogle ScholarPubMed
44.Menolascino, FJ, Osborne, RG. Psychiatric television consultation for the mentally retarded. Am J Psychiatry. 1970;127:515520.CrossRefGoogle ScholarPubMed
45.Rendon, M. Telepsychiatric treatment of a schoolchild. J Telemed Telecare. 1998;4:179182.CrossRefGoogle ScholarPubMed
46.Kaplan, EH. Telepsychotherapy. Psychotherapy by telephone, videotelephone, and computer videoconferencing. J Psychother Pract Res. 1997;6:227237.Google ScholarPubMed
47.Ghosh, GJ, MCLaren, PM, Watson, JP. Evaluating the alliance in videolink teletherapy. J Telemed Telecare. 1997;3:3335.CrossRefGoogle ScholarPubMed
48.American Psychiatric Association Committee on Telemedical Services. APA Resource Document on Telepsychiatry via Videoconferencing. July, 1998. Available at www.psych.org/psych_pract/tp_paper.cfm. Accessed on October 19, 2001.Google Scholar
49.Doze, S, Simpson, J, Hailey, D, Jacobs, P. Evaluation of a telepsychiatry pilot project. J Telemed Telecare. 1999;5:3846.CrossRefGoogle ScholarPubMed
50.Cohen, J. Statistical Power Analysis for the Behavioral Sciences. rev. ed. Hillsdale, NJ: Erlbaum; 1988.Google Scholar
51.Baigent, MF, Lloyd, CJ, Kavanagh, SJ, et al. Telepsychiatry: “tele” yes, but what about the “psychiatry”? J Telemed Telecare. 1997;3(suppl 1):35.CrossRefGoogle ScholarPubMed
52.Ball, CJ, Scott, N, McLaren, PM, Watson, JP. Preliminary evaluation of a low-cost videoconferencing (LCVC) system for remote cognitive testing of adult psychiatric patients. Br J Clin Psychol. 1993;32(pt 3):303307.CrossRefGoogle ScholarPubMed
53.Montani, C, Billaud, N, Tyrell, J, et al. Psychological impact of a remote psychometric consultation with hospitalized elderly people. J Telemed Telecare. 1997;3:140145.CrossRefGoogle ScholarPubMed
54.Grob, P, Weintraub, D, Sayles, D, Raskin, A, Ruskin, P. Psychiatric assessment of a nursing home population using audiovisual telecommunication. J Geriatr Psychiatry Neurol. 2001;14:6365.CrossRefGoogle ScholarPubMed
55.Jones, BN 3rd, Johnston, D, Reboussin, B, McCall, V. Reliability of psychiatric assessments: subjective versus observational ratings. J Geriatr Psychiatry Neurol. 2001;14:6671.CrossRefGoogle ScholarPubMed
56.Matsuura, S, Hosaka, T, Yukiyama, T, et al. Application of telepsychiatry: a preliminary study. Psychiatry Clin Neurosci. 2000;54:5558.CrossRefGoogle ScholarPubMed
57.Ruskin, PE, Reed, S, Kumar, R, et al. Reliability and acceptability of psychiatric diagnosis via telecommunication and audiovisual technology. Psychiatr Serv. 1998;49:10861088.CrossRefGoogle ScholarPubMed
58.Baer, L, Cukor, P, Jenike, MA, Leahy, L, O'Laughlen, J, Coyle, JT. Pilot studies of telemedicine for patients with obsessive-compulsive disorder. Am J Psychiatry. 1995;152:13831385.Google ScholarPubMed
59.Hedges, LV. Fitting categorical models to effect sizes from a series of experiments. Journal of Educational Statistics. 1982;92:119137.CrossRefGoogle Scholar
60.Zaylor, C. Telepsychiatry growing pains, managing 400 patients in 17 locations. Telemed J. 1999;5:5256.Google Scholar
61.Wittson, CL, Affleck, DC, Johnson, V. Two-way television in group therapy. Ment Hosp. 1961;2:2223.Google Scholar
62.Rohland, BM. Telepsychiatry in the heartland: if we build it, will they come? Community Ment Health J. 2001;37:449459.CrossRefGoogle ScholarPubMed
63.Dongier, M, Tempier, R, Lalinec-Michaud, M, Meunier, D. Telepsychiatry: psychiatric consultation through two-way television: a controlled study. Can J Psychiatry. 1986;31:3234.CrossRefGoogle ScholarPubMed
64.Elford, R, White, H, Bowering, R, et al. A randomized, controlled trial of child psychiatric assessments conducted using videoconferencing. J Telemed Telecare. 2000;6:7382.CrossRefGoogle ScholarPubMed
65.Baer, L, Brown-Beasley, MW, Sorce, J, Henriques, AI. Computer-assisted telephone administration of a structured interview for obsessive-compulsive disorder. Am J Psychiatry. 1993;150:17371738.Google ScholarPubMed
66.Baer, L, Jacobs, DG, Cukor, P, O'Laughlin, J, Coyle, JT, Magruder, KM. Automated telephone screening survey for depression. JAMA. 1995;273:19431944.CrossRefGoogle Scholar
87
Cited by

Send article to Kindle

To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Can Telepsychiatry Replace In-Person Psychiatric Assessments? A Review and Meta-Analysis of Comparison Studies
Available formats
×

Send article to Dropbox

To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

Can Telepsychiatry Replace In-Person Psychiatric Assessments? A Review and Meta-Analysis of Comparison Studies
Available formats
×

Send article to Google Drive

To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

Can Telepsychiatry Replace In-Person Psychiatric Assessments? A Review and Meta-Analysis of Comparison Studies
Available formats
×
×

Reply to: Submit a response

Please enter your response.

Your details

Please enter a valid email address.

Conflicting interests

Do you have any conflicting interests? *