Klinische Psychiatrie Offener Zugang

Abstrakt

Comparison of Efficacy in Depression and Stigma Reduction in Virtual In-Office Psychiatric Encounters with Virtual Out-of-Office Psychiatric Encounters among Adults in Louisiana

Lawrence Salone, Michael F. Burnett

The primary purpose of this study was to conduct a clinical trial to compare the provision of psychiatric evaluation and medication interventions in a Virtual Out of Office format (VOO) with the provision of psychiatric evaluation and medication interventions in a Virtual in-Office psychiatric encounter (VIO) among adults in Louisiana seeking psychiatric services for the treatment of depression. This study was classified as a pretest-posttest control group noninferiority double-blind experimental design. Each patient took a self-rated instrument at baseline and at week 8. The study tested the two interventions (VOO and VIO) by way of changes in overall function, changes in perceptions of stigma, and changes in rates of presentism. The final sample was 150 total number randomly assigned and 120 eligible participants providing usable data with 75 participants in VIO treatment group and 45 participants in VOO treatment group. The Virtual-Out-of-Office (VOO) treatment level was more effective in reducing the perceived Stigma associated with receiving psychiatric treatment than for the Virtual-in- Office (VIO) treatment. The VOO group had a significant reduction in the overall Stigma score (pre-test mean=1.97, post-test mean=1.52, t=2.629, df=24, p=0.015) and the Stigma-Intrinsic sub-scale score (pre-test mean=2.02, posttest mean=1.46, t=2.697, df=24, p=0.013) in the study. The VIO group showed no significant difference in any of the Stigma scores between pre-test and post-test measurements. The Virtual-Out-of-Office (VOO) treatment level was more efficacious in treating Depression associated with receiving psychiatric treatment than for the Virtual-in- Office (VIO) treatment group. The VOO group had a significant reduction in the Depression score (pre-test mean=3.05, post-test mean=1.71, t=5.406, df=24, p ≤ 0.001) in the study. Although the VIO group showed a significant reduction in the Depression score (pre-test mean=2.89, post-test mean=2.32, t=3.265, df=46, p=0.002), the VOO group showed a substantially greater reduction in Depression scores. Both treatment groups were effective in reducing depression which is consistent with literature and the practice of treating depression.