Telecommunications in psychiatry: what do we know and what should we consider next.

Introduction: Correspondence between Psychiatrists and patients has evolved through the years, and telecommunication means are ubiquitous. Although the use of synchronous and asynchronous interventions is becoming more prevalent in clinical practice, both for assessment and treatment, guidelines are scarce. Objectives: We aim to do a qualitative review of available literature. Methods: Search of PubMed database. Inclusion criteria: type of study, focus on direct telecommunication between psychiatrist and patient. Exclusion criteria: language constraints, inability to find full text online. Results: There were 2371 articles matching the search query. 87 were selected - 8 case reports, 15 clinical studies (including 5 randomized controlled trials), 61 literature reviews (of which 2 were systematic), and 3 meta-analyses. Publication date ranged from 1985-2019 (54,0% in the present decade). When defined, the population consisted of exclusively adults in 45,2% (of which 47,4% general population, 36,8% forensic, 10,5% geriatric) and 31,0% exclusively children and adolescents. Many studies focused on videoconferencing or phone communication, and few on digital media. Main areas of focus included effectiveness, acceptability, feasibility and ethics. The majority of studies showed good acceptability and non-inferiority of telecommunication mediated interventions, compared to in person interventions. Conclusions: The use of telecommunications in everyday Psychiatric practice raises many practical, ethical and security related issues. It is at least as effective as in-person interventions, and generally well accepted. It may present as a cost effective way to reach communities otherwise isolated from mental health care. Arguably, communication through digital and online media will become more frequent, and will need better characterization in future studies. [ABSTRACT FROM AUTHOR]