APPLICABILITY OF TELEMEDICINE FOR ASSESSING PATIENTS WITH SCHIZOPHRENIA - ACCEPTANCE AND RELIABILITY

Background: Telemedicine holds promise for providing expert psychiatri c consultation to underserved populations, but has not been quantitati vely studied in schizophrenia or any other major mental disorder. This study was conducted to assess the reliability and acceptance of video conferencing equipment in the assessment of patients with schizophreni a. Method: We assessed reliability of the Brief Psychiatric Rating Sca le (BPRS), Scale for the Assessment of Positive Symptoms (SAPS), and S cale for the Assessment of Negative Symptoms (SANS) under three condit ions: (1) in person, (2) by videoconferencing at low (128 kilobits per second [kbs]) bandwidth, (3) by videoconferencing at high (384 kbs) b andwidth. All 45 patients met DSM-IV criteria for schizophrenia. All p atients and the two interviewers rated various aspects of the study in terviews against previous live psychiatric interviews. Results: Total scores on both the BPRS and SAPS were assessed equally reliably by the three media. Total score on the SANS was less reliably assessed at th e low bandwidth, as were several specific negative symptoms of schizop hrenia that depend heavily on nonverbal cues. Video interviews were we ll accepted by patients in both groups, although patients in the high bandwidth group were more likely to prefer the video interview to a li ve interview. Conclusion: Global severity of schizophrenia and overall severity of positive symptoms were reliably assessed by videoconferen cing technology, Higher bandwidth resulted in more reliable assessment of negative symptoms and was preferred over low bandwidth, although p atients' and raters' acceptance of video was good in both conditions, Videoconsultation appears to be a reliable method of assessing schizop hrenic patients in remote locations who have limited access to expert consultation.