IntroductionNational and International telepsychiatry service was established between Denmark and Sweden in order to increase access to cross-cultural expertise. Patient acceptability study was conducted to assess the patients’ attitudes toward the quality, advantages and disadvantages of telepsychiatry service.MethodsOver a period January 2005-December 2007, 61 patients were treated via telepsychiatry by clinicians that speak patientsrespective mother tongues. Video-conferencing equipment connected the Little Prince Psychiatric Centre in Copenhagen with two hospitals, one asylum seekers’ centre and one social institution in Denmark. These stations were also connected to the Swedish department of the Centre. Number of languages spoken was 9 while the number of nationalities treated was 11. No interpreter assistance has been used.After the end of the telepsychiatry contact all patients were asked to complete a satisfaction questionnaire.ResultsPatients reported a high level of acceptance and satisfaction with telepsychiatry. They expressed a wish to use telepsychiatry via their mother tongue, rather than interpreter-assisted mental health care in the future.DiscussionThe restricted physical contact and non-verbal communication of telepsychiatry was compensated by the fact that the doctor and patient spoke the same language and had similar cultural and/or national references. The results of the survey may contribute to further development of, primarily, European Telepsychiatry Network. However, this model may be used for conducting of larger international telepsychiatry service capable to provide mental health care toward diversity of patient populations underserved on their mother tongue worldwide.

A telepsychiatry project was conducted to improve access to culturally appropriate care providers (i.e. culturally competent, bilingual clinicians) by the use of videoconferencing. A self-completed retrospective questionnaire survey was conducted with asylum seekers, refugees and migrants. The purpose of the referral was either for diagnostic assessment with a subsequent treatment recommendation, or for treatment via telepsychiatry. The service was free of charge for the patients involved. Over a period of 34 months (starting in January 2005), 61 patients participated in the pilot project. The patients' residency status was: refugees (n = 45), asylum seekers (n = 12), migrants (n = 3) and domestic (n = 1). A total of 318 telepsychiatry sessions (lasting 35-45 min) was conducted, with an average of 5.2 sessions per patient. Nine languages were spoken during the study period (Danish, Arabic, Farsi, Somali, Kurdish, Polish, Bosnian, Serbian and Croatian). A total of 52 patients completed the questionnaire. Patients reported a high level of satisfaction and willingness to use telepsychiatry again and recommend it to others. They preferred telepsychiatry via their mother tongue, rather than interpreter-assisted care.

An international telepsychiatry service was established between Denmark and Sweden for cross-cultural patient groups, such as asylum seekers, refugees and migrants. Over an 18-month period starting in mid 2006, 30 patients were treated by telepsychiatry (21 men and 9 women). The patients received mental health care by videoconferencing from providers who spoke the patients' own language, i.e. without the assistance of interpreters. The total number of telepsychiatry sessions was 203 (range 1-22; average 6.8 sessions per patient). Patients completed a satisfaction questionnaire at the end of treatment. Seven patients (23%) were not able to complete a questionnaire, due to illiteracy and/or a psychotic condition. The rest of the patients (n=23) reported a high level of acceptance and satisfaction with telepsychiatry, as well as a willingness to use it again or recommend it to others. Any disadvantages of telemedicine were compensated by the fact that the doctor and patient spoke the same language and had similar cultural and/or national references. Mentally ill asylum seekers, refugees and migrants are under-served in their mother tongue and telepsychiatry can improve access to scarce health-care resources.

The main aim was to develop recommendations on eMental health interventions for the treatment of psychotic disorders. A systematic literature search on eMental health interventions was performed, and 24 articles about interventions in psychotic disorders were retrieved and systematically assessed for their quality. Studies were characterized by a large heterogeneity with regard to study type, sample sizes, interventions and outcome measures. Five graded recommendations were developed dealing with the feasibility of eMental health interventions, beneficial effects of psychoeducation, preliminary results of clinical efficacy, the need of moderation in peer support eMental health groups and the need to develop quality standards.

Background: Cognitive impairment is associated with long-term disability that results in the deterioration of both the social and professional status of individuals with schizophrenia. The impact of antipsychotic therapy on cognitive function is insufficient. Cognitive training is therefore proposed as a tool for cognitive rehabilitation in schizophrenia. In this study we investigated the effect of self-administered cognitive training using a smartphone-based application on the cognitive function of paranoid schizophrenia patients focusing on response time, correct answer rate, incorrect answer rate, and fatigability to check, if these functions can be functional markers of successful cognitive-smartphone rehabilitation. Methods: 1-year multicenter, open-label randomized study was conducted on 290 patients in a state of symptomatic remission. 191 patients were equipped with the full version of the application and conducted cognitive training twice a week. Reference group (n = 99) was provided with a version of the application having only limited functionality, testing the cognitive performance of patients every 6 months. Results: Statistically significant improvement was observed in both the rate of correct answers (by 4.8%, p = 0.0001), and cognitive fatigability (by 2.9%, p = 0.0001) in the study group, along with a slight improvement in the rate of incorrect answers (by 0.9%, p = 0.15). In contrast, the reference group, who performed cognitive training every 6 months, demonstrated no significant changes in any cognitive activities. Conclusions: Cognitive trainings facilitated by a smartphone-based application, performed regularly for a longer period of time are feasible and may have the potential to improve the cognitive functioning of individuals with schizophrenia. Correct answers and cognitive fatigability have potential to be functional markers of successful smartphone-based psychiatric rehabilitations in schizophrenia patients.