Abstract

BackgroundAs in other countries worldwide, the prevalence of mental disorders in Germany is high. Although numerically a dense network of in- and outpatient psychiatric health services exists, the availability in rural and remote regions is insufficient.In rural regions, telemedical concepts can be a chance to unburden and complement the existing healthcare system. Telemedical concepts consisting of video or telephone consulting show first positive results, but there are only a few studies with a randomized controlled design.To improve the treatment of patients with mental disorders in rural regions, we developed a telemedical care concept based on telephone contacts and text-messages. The primary objective of this study is to evaluate the effects of the telemedical interventions on psychopathological outcomes, e. g. anxiety, depressive symptoms, and somatisation. Secondary objective of the study is the analysis of intervention effects on the frequency of medical contacts with healthcare services. Furthermore, the frequency of patients' crises and the frequency and kind of interventions, initiated by the project nurses will be evaluated. We will also evaluate the acceptance of the telemedical care concept by the patients.Methods/DesignIn this paper we describe a three-armed, randomized, controlled study. All participants are recruited from psychiatric day hospitals. The inclusion criteria are a specialist-diagnosed depression, anxiety disorder, adjustment disorder or a somatoform disorder and eligibility to participate in the study. Exclusion criteria are ongoing outpatient psychotherapy, planned interval treatment at the day clinic and expected recurrent suicidality and self-injuring behaviour.The interventions consist of regular patient-individual telephone consultations or telephone consultations with complementing text-messages on the patients' mobile phone. The interventions will be conducted during a time period of 6 months.Trial registrationThis study is registered in the German Clinical Trials Register (DRKS00000662).

Highlights

  • As in other countries worldwide, the prevalence of mental disorders in Germany is high

  • Epidemiology and utilization of health care services Surveys and cohort studies have shown that mental disorders have high prevalence rates in the general population worldwide

  • After treatment in a psychiatric day hospital, patients have to wait up to 6 months for further treatment in a regular outpatient psychotherapeutic practice. To bridge this long waiting period, we developed a telemedical concept consisting of regular, patient-centred telephone consultations and text-messages on the mobile phone, conducted by nurses of the University Hospital of Greifswald

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Summary

Introduction

As in other countries worldwide, the prevalence of mental disorders in Germany is high. To improve the treatment of patients with mental disorders in rural regions, we developed a telemedical care concept based on telephone contacts and text-messages. The primary objective of this study is to evaluate the effects of the telemedical interventions on psychopathological outcomes, e. Epidemiology and utilization of health care services Surveys and cohort studies have shown that mental disorders have high prevalence rates in the general population worldwide. 9 000 participants showed a lifetime prevalence of 46.4% for any mental disorder, thereof 28.8% for anxiety disorders and 20.8% for mood disorders [1]. The German Federal Health Survey of 1998 (Bundes-Gesundheitssurvey) showed a lifetime prevalence of 19% for depression [3].

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