Diagnostic Assessment via Live Telehealth (Phone or Video) Versus Face-to-Face for the Diagnoses of Psychiatric Conditions: A Systematic Review.

Objective: To determine the validity of telephone or video interviews, compared to face-to-face, for psychiatric diagnosis.

Data Sources: We searched MEDLINE, Embase, and PsycINFO from inception to June 22, 2023, and performed backward and forward citation analysis on all included studies on August 3, 2023.

Study Selection: We included primary studies comparing live telehealth (via telephone or videoconferencing) with face-to-face interviews using the same standardized diagnostic criteria for a mental health condition. Each patient had to undergo both modes of interviewing. Risk of bias was assessed using Quality Assessment of Diagnostic Accuracy Studies-2.

Results: This review included 35 studies. Seven are clinical studies that compare telehealth with face-to-face consultations for initial psychiatric diagnosis; telehealth via video or telephone is a reliable alternative for some specific disorders or for use in some specific populations that were studied. The other 28 studies compared telehealth to face-to-face interviews for the use of mental health standardized diagnostic instruments for a broad range of conditions, including depression, bipolar disorder, posttraumatic stress disorder, social anxiety disorder, and autism spectrum disorder, demonstrating good agreement and reliability. Telehealth holds promise for psychiatric assessments, especially when in-person evaluations are not feasible.

Conclusions: From the limited studies primarily conducted before the expansion of telehealth during the COVID-19 pandemic, several small studies suggest that telehealth's psychiatric diagnoses or assessments of various psychiatric conditions seem to be a viable option and should be considered for certain patients during situations, settings, or environments. More research is needed, as telehealth has become more broadly utilized.