Aim: This project sought to ascertain views and experiences of people with intellectual disabilities, their carers\', and specialist intellectual disability psychiatrists as to use of telepsychiatry consultations. Background: During the Covid-19 pandemic specialist psychiatrists in intellectual disability services in the United Kingdom (UK) have explored and adopted use of telepsychiatry for psychiatric consultations. Method: An easy-read co-designed questionnaire was sent to potential respondents N = 590 potential respondents (N = 280 patients, N = 280 carers), and a separate questionnaire was sent electronically to N = 30 specialist intellectual disability psychiatrists. Findings: Responses were received from N = 192 respondents (N = 68 (24%) patients, N = 98 (35%) carers, and N = 26 (90%)) psychiatrists. Advantages of telepsychiatry cited were flexibility, and it being less disruptive to patients\' routines, offering convenient practice and saving travel time and cost. Disadvantages reported included loss of rapport and relationship with patients, and an inability to conduct an effective mental state examination. Conclusion: This survey has produced equivocal evidence as to acceptability of telepsychiatry for all people with intellectual disabilities, carers and psychiatrists cannot be assumed. Some patients may need significant support to enable them to engage with such an approach.

暂无摘要。

Co-occurring intellectual/developmental disability (IDD) and overweight/obesity (OW/OB) is an important consideration of IDD psychiatric care. The relationship between OW/OB and comorbid diagnoses of Autism Spectrum Disorder (ASD) and/or IDD remains inadequately described in existing literature. The purpose of this study is to explore these co-occurring diagnoses. Improved understanding of associated comorbidities can guide clinicians toward interventions to minimize complications associated with OW/OB. We conducted a retrospective review of adult patients of a telepsychiatry clinic with IDD or ASD defined by DSM-5. ICD-10 diagnosis of IDD or ASD, demographics, BMI, comorbidities, and current medications were recorded. Binary logistic regression was used to estimate associations between each predictor and the outcomes overweight (body mass index (BMI) ≥ 25 kg/m2) and obesity (BMI ≥ 30 kg/m2). Prevalence of obesity in these 412 adults was 52.4% (95% CI 47.5, 57.3). There was a significant inverse relationship between IDD severity and the odds of each outcome (p < .001). 80.3% of patients were being actively treated with an antidepressant. Patients taking an antidepressant had twice the odds of obesity (adjusted OR 2.03, 95% CI 1.23, 3.41, p = .006). These findings provide a sense of urgency for prevention of OW/OB and its associated medical sequelae. Prevalence of obesity was higher in this sample compared to the general population. The inverse relationship between IDD severity and OW/OB warrants further research examining age, caregiver involvement, and access to care as potential modifiers.

UNASSIGNED: To conduct a systematic literature review of education and training (E&T) programs for telemental health (TMH) providers in the past 10 years to qualitatively clarify field offerings and methodologies, as well as identify areas for future growth.
UNASSIGNED: We searched five major electronic databases: PubMed, PsycINFO, Scopus, CINAHL, and Web of Science for original publications on TMH E&T from January 2013 to May 2023. We extracted information from each publication and summarized key features of training programs including setting, target group, study aims, training modality, methods of assessing quality, and outcomes.
UNASSIGNED: A total of 20 articles were selected for the final review. Articles meeting inclusionary criteria were predominantly comprised of case studies and commentaries, focused on a TMH service/practice for a specific region/population, and were performed after 2020. All of the selected studies demonstrated a significant increase in the measured knowledge, skills, and abilities of the participants after TMH training. Nevertheless, there remains a lack of standardization of training methodologies, limited sample sizes and demographics, variability in study methodologies, and inconsistency of competency targets across studies.
UNASSIGNED: This systematic review highlighted the diversity of methods for TMH E&T. Future research on this topic could include more varied and larger-scale studies to further validate and extend current findings, as well as explore potential long-term effects of TMH training programs on both provider attitudes and patient outcomes.

UNASSIGNED: Although the concept of telehealth is of great interest globally, its potential has not yet been realized in Pakistan. It is therefore essential to explore the perspectives of stakeholders on the technology, particularly for mental health, to be able to increase and improve its use.
UNASSIGNED: To assess the perceptions and experiences of patients receiving tele-mental health services, including telepsychiatry and tele-psychotherapy, in Pakistan.
UNASSIGNED: For this qualitative exploratory study, we conducted in-depth interviews with 49 individuals at a tertiary care hospital in Karachi, Pakistan. Using the Cresswell framework for content analysis, we identified 3 major themes that focused on the positive and negative aspects of tele-mental health services and made suggestions for enhancing them.
UNASSIGNED: Twenty-six of the participants received telepsychiatry, while the remaining 23 received tele-psychotherapy services. Technical literacy, cost of consultation, privacy, and therapeutic alliance were the major challenges identified by the patients, while convenience and the absence of stigma were highlighted as key facilitators for tele-mental health. Tele-consultations reduced travel and waiting time, thus improving access to healthcare. Participants suggested that the processes for booking appointments and making payments should be streamlined and the cost of tele-consultation reduced.
UNASSIGNED: This study provides insightful findings on tele-mental health services from the perspectives of patients living in an Asian culture. The major benefits highlighted were destigmatization of mental health and elimination of commuting costs and travel time. There were concerns about privacy, therapeutic alliance and availability and affordability of the technology.
تجارب المرضى في باكستان في خدمات الصحة النفسية عن بُعد في أثناء جائحة كوفيد-19.
نرجس أسد، شاهينا بيراني، خان أسامة، تانيا نديم.
UNASSIGNED: على الرغم من أن مفهوم الصحة عن بُعد يحظى بأهمية كبيرة على الصعيد العالمي، فإنه لم يجرِ تقصِِّّي كامل إمكاناته في باكستان بعدُ. لذلك، من الضروري استكشاف وجهات نظر أصحاب المصلحة بشأن هذه التكنولوجيا، لا سيَّما في مجال الصحة النفسية، للتمكن من زيادة استخدام هذه التكنولوجيا وتحسينها.
UNASSIGNED: هدفت هذه الدراسة الى تقييم تصورات وتجارب المرضى الذين يتلقون خدمات الصحة النفسية عن بُعد في باكستان، ومن ذلك الطب النفسي عن بُعد والعلاج النفسي عن بُعد.
UNASSIGNED: من أجل هذه الدراسة الاستكشافية الوصفية، أجرينا مقابلات وافية مع 49 فردًا في مستشفى للرعاية التخصصية في كراتشي، في باكستان. وباستخدام إطار كريسويل لتحليل المحتوى، حددنا 3 مواضيع رئيسية ركزت على الجوانب الإيجابية والسلبية لخدمات الصحة النفسية عن بُعد، وقدَّمنا اقتراحات لتعزيزها.
UNASSIGNED: تلقَّى ستة وعشرون مشاركًا خدمات الطب النفسي عن بُعد على يد طبيب نفسي، في حين تلقَّى الثلاثة والعشرون مشاركًا الباقون خدمات العلاج النفسي عن بُعد على يد معالج نفسي. وكانت القراءة والكتابة التقنية، وتكلفة الاستشارة، والخصوصية، والتحالف العلاجي من التحديات الرئيسية التي حددها المرضى، في حين سُلط الضوء على الراحة وعدم الوصم باعتبارهما ميسرين رئيسيين للصحة النفسية عن بُعد. وخفضت الاستشارات عن بُعد إلى وقت السفر والانتظار، الأمر الذي أدى إلى تحسين فرص الحصول على الرعاية الصحية. واقترح المشاركون تبسيط عمليات حجز المواعيد وتسديد المدفوعات، وخفض تكلفة الاستشارة عن بُعد.
UNASSIGNED: تقدم هذه الدراسة نتائج متعمقة بشأن خدمات الصحة النفسية عن بُعد من وجهة نظر المرضى الذين يعيشون في ثقافة آسيوية. وإزالة الوصمة عن الصحة النفسية والتخلص من تكاليف التنقل ووقت السفر كانت من أهم الفوائد التي سُلِّط الضوء عليها. وكانت ثمة شواغل بشأن الخصوصية والتحالف العلاجي وتوفُّر التكنولوجيا والقدرة على تحمُّل تكاليفها.
Expériences des patients avec les services de télésanté mentale pendant la COVID-19 au Pakistan.
UNASSIGNED: Bien que le concept de la télésanté présente un grand intérêt à l\'échelle mondiale, son potentiel n\'a pas encore été pleinement exploré au Pakistan. Il est donc essentiel d\'explorer les perspectives des parties prenantes concernant la technologie, en particulier pour la santé mentale, afin de pouvoir augmenter et améliorer son utilisation.
UNASSIGNED: Évaluer les perceptions et les expériences des patients recevant des services de télésanté mentale, y compris la télépsychiatrie et la télépsychothérapie, au Pakistan.
UNASSIGNED: Pour cette étude qualitative exploratoire, nous avons mené des entretiens approfondis avec 49 personnes dans un hôpital de soins tertiaires à Karachi (Pakistan). En utilisant le cadre de Cresswell pour l\'analyse de contenu, nous avons identifié trois thèmes principaux qui se concentrent sur les aspects positifs et négatifs des services de télésanté mentale et nous avons proposé des suggestions pour les améliorer.
UNASSIGNED: Vingt-six des participants ont bénéficié de services de télépsychiatrie, tandis que les 23 autres ont reçu des services de télépsychothérapie. La littératie technique, le coût de la consultation, le respect de la vie privée et l\'alliance thérapeutique étaient les principaux défis identifiés par les patients, alors que la commodité et l\'absence de stigmatisation étaient soulignées comme des éléments clés qui facilitaient la pratique de télésanté mentale. Les téléconsultations ont permis de réduire les déplacements et les temps d\'attente, améliorant ainsi l\'accès aux soins de santé. Les participants ont suggéré de rationaliser les procédures de prise de rendez-vous et de paiement et de réduire le coût de la téléconsultation.
UNASSIGNED: La présente étude fournit des résultats pertinents sur les services de télésanté mentale du point de vue des patients qui vivent dans une culture asiatique. Les principaux avantages mis en évidence étaient la déstigmatisation de la santé mentale et l\'élimination des coûts et du temps de déplacement. Des inquiétudes ont été exprimées concernant le respect de la vie privée, l\'alliance thérapeutique, la disponibilité et l\'accessibilité financière de la technologie.

BACKGROUND: Prisoners are often associated with mental health and substance use disorders. Coercive measures are widely used in prison settings. The objective of this study was to compare inmates\' perceptions and satisfaction with telepsychiatry versus face-to-face consultation and the effects of telepsychiatry on the use of coercive measures. The sample consisted of 100 male inmates from various backgrounds who had experienced both approaches of services (face to face and telepsychiatry).
METHODS: The data were obtained through an interview where the individuals completed a Demographic Data Questionnaire, a Participant Satisfaction Questionnaire to assess satisfaction with face-to-face psychiatric services, and a Participant Satisfaction Questionnaire to assess their satisfaction with services offered via telepsychiatry. Additionally, calculations of time spent waiting for a face-to-face psychiatric evaluation and time spent in handcuffs and in confined spaces were made before and after the introduction of telepsychiatry.
RESULTS: Statistically significant improvements (all p-values < 0.001) were noted in waiting times, support for relapse prevention, follow up, quality of mental health care, quality of care in the management of psychiatric problems and related medication, behavior of psychiatrists, duration of the assessment, sense of comfort, and confidentiality. Telepsychiatry led to the elimination of time spent in handcuffs and in confined spaces (transport vehicles).
CONCLUSIONS: According to the results of this study, telepsychiatry is an acceptable method of service delivery in correctional facilities and was associated with a reduction of coercive practices.

UNASSIGNED: Telehealth services ensure the delivery of healthcare services to a wider range of consumers through online platforms. Nonetheless, the acceptance and uptake of telehealth remain elusive. This study aims to understand the (a) uptake and (b) acceptability of telemedicine, (c) if therapeutic alliance mediates the relationship between the frequency of consultations with clinicians and the uptake of telemedicine in patients with early psychosis, and (d) role of education in moderating the relationship between therapeutic alliance and the uptake of telemedicine for their mental healthcare.
UNASSIGNED: A convenience sample of outpatients (n = 109) seeking treatment for early psychosis and their care providers (n = 106) were recruited from a tertiary psychiatric care centre. Sociodemographic and clinical characteristics, therapeutic alliance (Working Alliance Inventory), and telemedicine use were captured through self-administered surveys. The moderated mediation analysis was performed using PROCESS macro 3.4.1 with therapeutic alliance and level of education as the mediating and moderating factors, respectively.
UNASSIGNED: The acceptance of telemedicine was high (possibly will use: 47.7%; definitely will use: 26.6%) whilst the uptake was low (11%). Therapeutic alliance mediated the relationship between the frequency of consultation and the uptake of telemedicine (β: 0.326; CI: 0.042, 0.637). This effect was moderated by the level of education (β: -0.058; p < 0.05).
UNASSIGNED: Therapeutic alliance mediates the relationship between the frequency of consultations and the uptake of telemedicine services with the level of education moderating this mediation. Focusing on the patients with lower education to improve their telemedicine knowledge and therapeutic alliance might increase the uptake.

UNASSIGNED: To describe staff experiences with the use of videoconferences with forensic psychiatric outpatients during the COVID-19 pandemic.
UNASSIGNED: Semi-structured interviews with staff at forensic community services in the Region of Southern Denmark.
UNASSIGNED: Nine semi-structured staff interviews were conducted. Two main themes were identified through thematic analysis: Challenges due to technical uncertainty and the Use of videoconferences as support in clinical assessment and treatment. The second main theme also included a number of subthemes: Lack of opportunity for observation of a patient\'s overall situation; Compromise of nurses\' professionalism; Limitation of disturbing stimuli means more focus on the conversation; Telephone contact vs. video contact-pros and cons; Expectations reflect attitudes; and Will professionalism be changed based on organizational and political perspectives?
UNASSIGNED: Staff opinions on use of videoconferences in psychiatric patients differed. The nurses in particular were concerned about whether professionalism could be maintained. Others experienced patients focusing more on the conversation when it took place via video because there were fewer disturbing elements. In general, expectations seem to influence attitudes toward using videoconferences.

UNASSIGNED: Psychosocial interventions help maintain alcohol abstinence. Third-wave psychotherapies have emerged as an alternative to cognitive behavioral therapies for Alcohol Use Disorder (AUD) treatment. However, third-wave therapies have not been tested in non-western settings or via telehealth.
UNASSIGNED: We assessed the acceptability and feasibility of Acceptance and Commitment Therapy (ACT) in moderate/severe AUD.
UNASSIGNED: This was a pre- and post-study design. All those who met the eligibility (n = 40) criteria consented to participate. A trained nurse delivered four sessions of ACT, either in-person or via video-conferencing, per participants\' preference. Alcohol use, craving, relapse signs, and psychological flexibility were assessed three months post-intervention.
UNASSIGNED: Twenty-eight participants (70%) attended all four sessions. There was a significant increase in abstinence and a decrease in alcohol use, frequency of drinking/heavy drinking, craving, relapse signs, and improved psychological flexibility. Outcomes were positive for either mode of delivery.
UNASSIGNED: ACT is feasible, acceptable, and probably effective in AUD.

UNASSIGNED: The COVID-19 pandemic led to a prompt implementation of remote care, especially in mental health care. The evidence supporting this modality of care is still emerging, with few qualitative studies describing its implementation in Latin American countries. This study aims to understand the perspectives of therapists and patients regarding the use of telehealth in a child and adolescent mental health unit of a Chilean public service.
UNASSIGNED: This is a qualitative study. Two focus groups were defined with 14 professionals, and 16 in-depth interviews were conducted with users of an outpatient child and adolescent psychiatry unit. The data were analyzed using the grounded theory model.
UNASSIGNED: In the group of therapists, four main categories emerged: background of mental telehealth, implementation, mental telehealth from the therapist\'s position, and projections. Three main categories emerged in the patient\'s group: implementation, evaluation of mental telehealth users, and projections.
UNASSIGNED: There are elements in common between the opinions of patients and therapists. Something to note within the patient\'s group is that, despite accepting remote care and recognizing its positive aspects, aside from the pandemic context, they prefer face-to-face or mixed care.
UNASSIGNED: La pandemia por COVID-19 generó una implementación súbita de las atenciones a distancia, especialmente en atenciones de salud mental. La evidencia que sustenta esta modalidad de atención es aún emergente, con escasos estudios cualitativos que representen su implementación en países latinoamericanos. El objetivo de este trabajo es conocer la perspectiva de terapeutas y de usuarios, respecto del uso de la telesalud en una unidad de salud mental infantil y de la adolescencia de un servicio público chileno.
UNASSIGNED: Estudio cualitativo. Se establecieron dos grupos focales con 14 profesionales en total, y 16 entrevistas en profundidad con usuarios de una unidad ambulatoria de psiquiatría infanto juvenil.. Los datos se analizaron utilizando el modelo de teoría fundamentada.
UNASSIGNED: En el grupo de terapeutas surgen cuatro categorías fundamentales; antecedentes de la telesalud mental, implementación, telesalud mental desde la posición del terapeuta y proyecciones. En el grupo de usuarios surgieron tres categorías principales: implementación, evaluación de los usuarios de la telesalud mental y proyecciones.
UNASSIGNED: Existen elementos en común entre la opinión de los usuarios y terapeutas. Un elemento importante dentro del grupo de los usuarios es que, a pesar de aceptar la atención remota y reconocer aspectos positivos en esta, fuera del contexto de pandemia prefieren atenciones presenciales o mixtas.