Japanese project for telepsychiatry evaluation during COVID-19: Treatment comparison trial (J-PROTECT): Rationale, design, and methodology

Analyzing changes in help-seeking from mental and physical health professionals during COVID-19 in Japan

Japan witnessed the outbreak of coronavirus disease (COVID-19) in March - May 2020. We examined whether the impact of COVID-19 on people seeking help from mental and physical health professionals varied with changes in employment (from full-time employment to unemployment or leave of absence) and psychological predisposition to new-type depression (Interpersonal Sensitivity [IS]/Privileged Self [PS]) associated with the pandemic. An online survey was conducted in June 2020 (after the outbreak of COVID-19) among people who were full-time employees as of April 2019. Data from 1,053 individuals were analyzed. The survey asked about regular visits to health professionals one year prior to the survey (June 2019) and at the time of the survey. Employment status, personality traits, and demographic characteristics were also examined. We found that consultation rates changed little before and after the pandemic. Logistic regression analysis showed that after controlling for age and gender, being unemployed or absent from work after the pandemic and having higher scores for IS/PS were positively associated with regular visits to health professionals. Considering that COVID-19 has been shown to increase the incidence of physical and mental illness, the finding that the rate of consultations remained unchanged implies that consultations were withheld. Joblessness/absence from work and IS/PS had negative effects on physical and mental health, leading to fewer visits.

Live two-way video versus face-to-face treatment for depression, anxiety, and obsessive-compulsive disorder: A 24-week randomized controlled trial

AIM

Live two-way video, easily accessible from home via smartphones and other devices, is becoming a new way of providing psychiatric treatment. However, lack of evidence for real-world clinical setting effectiveness hampers its approval by medical insurance in some countries. Here, we conducted the first large-scale pragmatic, randomized controlled trial to determine the effectiveness of long-term treatment for multiple psychiatric disorders via two-way video using smartphones and other devices, which are currently the primary means of telecommunication.

METHODS

This randomized controlled trial compared two-way video versus face-to-face treatment for depressive disorder, anxiety disorder, and obsessive-compulsive disorder in the subacute/maintenance phase during a 24-week period. Adult patients with the above-mentioned disorders were allocated to either a two-way video group (≥50% video sessions) or a face-to-face group (100% in-person sessions) and received standard treatment covered by public medical insurance. The primary outcome was the 36-Item Short-Form Health Survey Mental Component Summary (SF-36 MCS) score. Secondary outcomes included all-cause discontinuation, working alliance, adverse events, and the severity rating scales for each disorder.

RESULTS

A total of 199 patients participated in this study. After 24 weeks of treatment, two-way video treatment was found to be noninferior to face-to-face treatment regarding SF-36 MCS score (48.50 vs 46.68, respectively; p < 0.001). There were no significant differences between the groups regarding most secondary end points, including all-cause discontinuation, treatment efficacy, and satisfaction.

CONCLUSION

Two-way video treatment using smartphones and other devices, was noninferior to face-to-face treatment in real-world clinical settings. Modern telemedicine, easily accessible from home, can be used as a form of health care.

A systematic review of studies on stress during the COVID-19 pandemic by visualizing their structure through COOC, VOS viewer, and Cite Space software

Background

The COVID-19 epidemic generated different forms of stress. From this period, there has been a remarkable increase in the quantity of studies on stress conducted by scholars. However, few used bibliometric analyses to focus on overall trends in the field.

Purpose

This study sought to understand the current status and trends in stress development during COVID-19, as well as the main research drives and themes in this field.

Methods

2719 publications from the Web of Science(WOS) core repository on stress during COVID-19 were analyzed by utilizing Co-Occurrence (COOC), VOS viewer, and Cite Space bibliometric software. The overall features of research on stress during COVID-19 were concluded by analyzing the quantity of publications, keywords, countries, and institutions.

Results

The results indicated that the United States had the largest number of publications and collaborated closely with other countries with each other. University of Toronto was the most prolific institution worldwide. Visualization and analysis demonstrated that the influence of stress during COVID-19 on the work, life, mental and spiritual dimensions is a hot research topic. Among other things, the frequency of each keyword in research on stress during COVID-19 increased from 2021 to 2022, and the researchers expanded their scope and study population; the range of subjects included children, nurses, and college students, as well as studies focusing on different types of stress, and emphasizing the handling of stress.

Conclusion

Our findings reveal that the heat of stress research during COVID-19 has declined, and the main research forces come from the United States and China. Additionally, subsequent research should concern more on coping methods with stress, while using more quantitative and qualitative studies in the future.

Psychiatric treatment conducted via telemedicine versus in-person consultations in mood, anxiety and personality disorders: a protocol for a systematic review and meta-analysis

INTRODUCTION

Major advancements in technology have led to considerations how telemedicine (TM) and other technology platforms can be meaningfully integrated in treatment for psychiatric disorders. The COVID-19 pandemic has placed a further focus on use of TM in psychiatry. Despite the widespread use of TM, little is known about its effect compared with traditional in-person (IP) consultation. The objective of this systematic review is to examine if individual psychiatric outpatient interventions for adults using TM are comparable to IP in terms of (1) psychopathology outcomes, (2) levels of patient satisfaction, (3) working alliance and (4) dropout from treatment.

METHODS AND ANALYSIS

This review will only include randomised controlled trials for adult participants with mood disorders, anxiety or personality disorders. The primary outcome is psychopathology, and secondary outcomes include patient satisfaction, treatment alliance and dropout rate. Systematic searches were conducted in MEDLINE, APA PsycINFO, Embase, Web of Science and CINAHL. The inverse-variance method will be used to conduct the meta-analysis. Effect sizes will be calculated as standardised mean difference (Hedges' g) for the primary outcome, mean difference for patient satisfaction and working alliance, and risk ratio for the dropout rate. Effect sizes will be supplemented with 95% CI. We will calculate the I² statistic to quantify heterogeneity and Chi-square statistic (χ²) to test for heterogeneity for the primary outcome. Potential clinical and methodological heterogeneity moderators will be assessed in subgroup and sensitivity analysis. The risk of bias will be assessed by Cochrane Risk of Bias Tool V.2, and confidence in cumulative evidence will be assessed by Grading of Recommendations Assessment, Development and Evaluation.

ETHICS AND DISSEMINATION

No ethical approval is required for this systematic review protocol. Data sets will be deposited in the Zenodo repository. The findings of this study will be published in a peer-review scientific journal.

PROSPERO REGISTRATION NUMBER

CRD42021256357.

Current Status and Challenges of the Dissemination of Telemedicine in Japan After the Start of the COVID-19 Pandemic

Background: The use of telemedicine is expanding worldwide in response to the COVID-19 pandemic, and deregulation is occurring even in countries with strict regulations, such as Japan. Methods: We conducted a narrative review of the activities and initiatives undertaken by the government and professional organizations to promote the use of telemedicine in Japan from January 2020, when the COVID-19 pandemic began, to September 2021. Results: In Japan, where before the pandemic the spread of telemedicine had been limited, various recommendations and deregulations have now been made, resulting in the expanded use of telemedicine. In particular, the government's overall policy direction has become a catalyst for deregulation. Conclusions: With the COVID-19 pandemic, telemedicine is now moving toward widespread use. However, further activities and initiatives, including policy changes such as reimbursement and the establishment of evidence to show the effectiveness of telemedicine in Japan, are needed to properly disseminate telemedicine.