Background: The COVID-19 pandemic has transformed healthcare significantly and telepsychiatry is now the primary means of treatment in some countries.
Aims: To compare the efficacy of telepsychiatry and face-to-face treatment.
Method: A comprehensive meta-analysis comparing telepsychiatry with face-to-face treatment for psychiatric disorders. The primary outcome was the mean change in the standard symptom scale scores used for each psychiatric disorder. Secondary outcomes included all meta-analysable outcomes, such as all-cause discontinuation and safety/tolerability.
Results: We identified 32 studies ( = 3592 participants) across 11 mental illnesses. Disease-specific analyses showed that telepsychiatry was superior to face-to-face treatment regarding symptom improvement for depressive disorders ( = 6 studies, = 561; standardised mean difference s.m.d. = -0.325, 95% CI -0.640 to -0.011, = 0.043), whereas face-to-face treatment was superior to telepsychiatry for eating disorder ( = 1, = 128; s.m.d. = 0.368, 95% CI 0.018-0.717, = 0.039). No significant difference was seen between telepsychiatry and face-to-face treatment when all the studies/diagnoses were combined ( = 26, = 2290; = 0.248). Telepsychiatry had significantly fewer all-cause discontinuations than face-to-face treatment for mild cognitive impairment ( = 1, = 61; risk ratio RR = 0.552, 95% CI 0.312-0.975, = 0.040), whereas the opposite was seen for substance misuse ( = 1, = 85; RR = 37.41, 95% CI 2.356-594.1, = 0.010). No significant difference regarding all-cause discontinuation was seen between telepsychiatry and face-to-face treatment when all the studies/diagnoses were combined ( = 27, = 3341; = 0.564).
Conclusions: Telepsychiatry achieved a symptom improvement effect for various psychiatric disorders similar to that of face-to-face treatment. However, some superiorities/inferiorities were seen across a few specific psychiatric disorders, suggesting that its efficacy may vary according to disease type.
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| http://dx.doi.org/10.1192/bjp.2023.86 | DOI Listing |
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