Remote video consultations show positive impact on depression and anxiety

A study published today in The BMJ reveals that remote video consultations between patients and mental health specialists can lead to modest but significant improvements in symptoms of depression and anxiety.

Although the effects were small, the researchers emphasize that the improvement is still meaningful, given the widespread prevalence of these disorders in the general population.

Depression and anxiety are among the leading causes of disability worldwide, yet most individuals with these conditions are treated in primary care settings, where access to specialized mental health services is limited. While previous research has demonstrated the effectiveness of telemedicine in primary care, there is little evidence regarding its impact when mental health specialists provide remote consultations to patients in these settings.

To address this gap, researchers in Germany tested a new video consultation model called PROVIDE, designed to connect patients with symptoms of depression and anxiety in primary care to mental health specialists.

The study included 376 adults (average age 45, 63% women) who visited their general practitioner (GP) for moderate-to-severe depression or anxiety between March 2020 and November 2021. Symptom severity was measured using the Patient Health Questionnaire Anxiety and Depression Scale (PHQ-ADS), and participants were randomly assigned to either the PROVIDE model or usual care.

The PROVIDE model involved five 50-minute video sessions of brief psychotherapy over eight weeks, connecting patients in their GP’s office with an offsite mental health specialist. Usual care, provided by the GP, included brief counseling, medication, and referrals to specialists.

After six months, the PROVIDE model resulted in a small but meaningful reduction in depressive and anxiety symptoms (an average decrease of 2.4 points on the PHQ-ADS scale) compared to usual care. This improvement was sustained at 12 months, with an average reduction of 2.9 points. Additionally, the PROVIDE model was more effective at alleviating psychological distress related to physical (somatic) symptoms, although it did not significantly impact overall recovery rates.

No serious adverse events were reported in either group.

The researchers acknowledged some limitations, including challenges in achieving a fully representative sample in clinical research and the impact of missing data. While the effect size was below the minimal clinically important difference (3-5 points on the PHQ-ADS), they argue that the improvements remain meaningful given the high prevalence of depression and anxiety in the community.

The study concludes that while further research is needed to refine and optimize such interventions, the PROVIDE model shows potential as a scalable solution that could improve mental health outcomes on a broader scale.