The
characteristic differences between clients of
virtual and
real psychiatric clinic in Taiwan
Ya-Mei Bai, Chao-Cheng Lin, Jen-Yeu Chen, Win-Chien Liu
American
Journal of Psychiatry
2001: 158: 7: 1160-1161
The
Internet is an increasing popular means of communicating for
physicians
and their patients. Psychiatry and Psychotherapy seem to be two
of the most promising medical fields in
which to carry on diagnostic and therapeutic
activities in virtual reality
(1).We designed and implemented a noncommercial virtual
psychiatric clinic (http://www.psychpark.net/clinic).
Web visitors can ask questions
about psychiatric problems by
e-mail, then our professionals e-mail the answers back.
The clients can ask further
questions. Our service is free of charge for clients. There
are more than 80 volunteer professionals in our
clinic, including psychiatrist, psychologist,
social worker, occupational therapist and
psychiatric nurse.
The characteristics of the 66 clients in our virtual clinic were compared with 42
clients
on their first visits
to a psychiatric outpatient clinic located in downtown Taipei .
There were significant differences between them. The clients of
our virtual clinic were
significantly younger than the outpatients ( mean age=28.9 years,
SD=6.1,
versus 35.8 years, SD=14.3, respectively) ( t= 2.93, df=49.4, p=0.005,
two-tailed),
more had a college education
(N=44, 66.7% , versus N=12, 28.6%; Pearson's X2 =35.4,
df=5, p=0.001, two-tailed), and
more had never previously visited a psychiatric clinic
(N=29, 43.9%, versus N=6,
14.3%, p=0.001, Fisher's exact test, two-tailed). Among clients
who had visited real
psychiatric clinics, there were significant
difference in the types of previous
diagnosis between the two groups
(Pearson X2= 12.33, df=4, p=0.02, two-tailed). The most
common diagnosis of the clients
of the virtual clinic was
anxiety disorder (panic disorder,
obsessive-compulsive disorder,
or generalized anxiety
disorder) (N=36, 54.5%); the most
common diagnosis for the clients
of the real clinic was
mood disorder (depression or bipolar
disorder) (N=20, 48.6%).
In
a study of Milton et al. of an Internet anxiety disorder program(2), all patients were young,
well-educated, male
and high socioeconomic status-all characterisitcs of Internet users.
He
suggested that anxiety plays a part in the different ways
in which they sought help, and such
patients could be predisposed to using computers to obtain information or to
obtain access to
resources to understand their problems (2).
Our study result was compatible with those of Milton
et al. Our web clients were also young and highly educated,
they had more anxiety-related disorder,
and most of them had not visit a real psychiatric clinic before.
Clients who might have had trouble
expressing their feelings in face-to-face
sessions were able to discuss them freely through e-mail (3).
The convenience
and privacy of virtual psychiatric clinics may increase some patients' motivation to
seek help
from mental professionals. Although, to our knowledge, there are no articles comparing the
efficacy of
web-base treatment and real clinic, the Internet is a way to educate and reach potential
patients. Understanding the characteristics of web clients may
improve further online services to meet
the needs of
different health care consumers.
Reference:
(1) Green
B: Psychaitry and the Net. Psychiatr Bull 1996; 20: 36-37
(2)
Milton PH, Rajaprabhakaran PR, James LA, Norman EA: Case Studies of the
Internet:
Experiences at an Anxiety Disorders Program. M.D. Computing 1998;4(15):
238-241
(3)
Cameron Johnson: Psychiatrist says counseling via e-mail may be yet
another medical use
for
Internet. Can Med Assoc J 1996; 155(11): 1606-1607