Child and adolescent telepsychiatry: Reliability studies needed

The progress of child and adolescent psychiatry has been greatly influenced by the development and implementation of diagnostic reliability studies. T he key components of these studies have been the use of standardized struct ured interviews, the use of trained interviewers, and reliability designs t hat confirm the level of interrater reliability for a diagnosis or a number of diagnoses in a specific clinical environment. Despite the impact of the methodologies associated with these studies and their acceptance as standa rds, there are no comparable studies in child and adolescent telepsychiatry that use similar research methodologies or technologies. Most of the child and adolescent telepsychiatry literature is represented by program descrip tions and patient/practitioner satisfaction surveys evaluating the acceptan ce of the technology and the care delivered via telepsychiatry. The use of standardized measures and methodologies constitute the essential components of the science of child and adolescent psychiatry. Their use validates stu dies for practitioners as acceptable and allows the field to grow. Their ab sence undermines the credibility of any study and decreases its acceptance. Without science to substantiate the enthusiasm often expressed by those im plementing systems of telepsychiatry, little progress will occur. Reviewed are structured interviews used in child and adolescent psychiatry research, a critique of current designs, and potential considerations for the develo pment of studies in child and adolescent telepsychiatry research.