[Telemedicine for mental disorders: Presentation and initial results of a telephone-based care approach]

A telephone-based health program for people with depressive and anxiety disorders as well as stress, already implemented in the standard care of a private health insurance company, as well as the initial evaluation results will be presented.

The program, based on several months of telephone support for patients from medical professionals, focuses on teaching psychoeducational content, behavioral therapy techniques, and emotional support. In the current program, the German version of the DASS 21 questionnaire was used, which detects distress in the dimensions of depression, anxiety and stress as well as overall psychological stress. The demographic data and the questionnaire results of all participants from the first eleven months of the program, who completed questionnaires at two time points, are presented. The reductions in the DASS 21 (sub)scores after five months of coaching were defined as the primary endpoints. The basis for calculation was the t-test for dependent samples (α=0.05).

Two completed questionnaires were available from 86 of 199 participants (43.2%). The population was on average 49.5 years old and predominantly female (61.6%). In total, coaching lasted 170 (SD=58) days and 200 (81) minutes. On average, these minutes were distributed over 5.6 (1.9) calls. At baseline, there were increased scores in all subcategories (depression: 7.13 [4.99]; anxiety: 4.49 [4.07]; stress: 9.85 [4.16]; total: 21.47 [11.54]). After five months, a reduction in each parameter was measured (depression: - 2.14 [3.99], Cohen's d=0.54; anxiety: - 1.65 [3.36], d=0.49; stress: - 2.24 [4.81], d=0.47; total: - 6.03 [10.70]; d=0.56; p < 0.001 for each). Broken down by severity of stress at the start of care, several subcategories showed an increase in score reduction with increasing severity, with medium to large effect sizes.

The telephone program described is promising as an accompanying approach to treatment of mental illness. Due to the pre-post study design, the results presented do not allow a final statement to be made about the effectiveness of the program. However, based on the significant improvements in psychological stress shown over the course of the program, including relevant effect sizes, a further evaluation of this setting under controlled conditions is recommended.