The COVID-19 pandemic has transformed healthcare significantly and telepsychiatry is now the primary means of treatment in some countries.

To compare the efficacy of telepsychiatry and face-to-face treatment.

A comprehensive meta-analysis comparing telepsychiatry with face-to-face treatment for psychiatric disorders. The primary outcome was the mean change in the standard symptom scale scores used for each psychiatric disorder. Secondary outcomes included all meta-analysable outcomes, such as all-cause discontinuation and safety/tolerability.

We identified 32 studies (n = 3592 participants) across 11 mental illnesses. Disease-specific analyses showed that telepsychiatry was superior to face-to-face treatment regarding symptom improvement for depressive disorders (k = 6 studies, n = 561; standardised mean difference s.m.d. = −0.325, 95% CI −0.640 to −0.011, P = 0.043), whereas face-to-face treatment was superior to telepsychiatry for eating disorder (k = 1, n = 128; s.m.d. = 0.368, 95% CI 0.018–0.717, P = 0.039). No significant difference was seen between telepsychiatry and face-to-face treatment when all the studies/diagnoses were combined (k = 26, n = 2290; P = 0.248). Telepsychiatry had significantly fewer all-cause discontinuations than face-to-face treatment for mild cognitive impairment (k = 1, n = 61; risk ratio RR = 0.552, 95% CI 0.312–0.975, P = 0.040), whereas the opposite was seen for substance misuse (k = 1, n = 85; RR = 37.41, 95% CI 2.356–594.1, P = 0.010). No significant difference regarding all-cause discontinuation was seen between telepsychiatry and face-to-face treatment when all the studies/diagnoses were combined (k = 27, n = 3341; P = 0.564).

Telepsychiatry achieved a symptom improvement effect for various psychiatric disorders similar to that of face-to-face treatment. However, some superiorities/inferiorities were seen across a few specific psychiatric disorders, suggesting that its efficacy may vary according to disease type.

COVID-19 大流行极大地改变了医疗保健，远程精神病学现已成为一些国家的主要治疗手段。

比较远程精神病学和面对面治疗的疗效。

比较远程精神病学与面对面治疗精神疾病的综合荟萃分析。主要结果是用于每种精神疾病的标准症状量表评分的平均变化。次要结局包括所有可荟萃分析的结局，例如全因停药和安全性/耐受性。

我们确定了针对 11 种精神疾病的 32 项研究（n = 3592 名参与者）。疾病特异性分析表明，在抑郁症症状改善方面，远程精神病学优于面对面治疗（k = 6项研究，n = 561；标准化均数差smd = -0.325，95% CI -0.640至-0.011，P = 0.043），而对于饮食失调，面对面治疗优于远程精神病学（k = 1，n = 128；smd = 0.368，95% CI 0.018–0.717，P = 0.039）。当所有研究/诊断结合起来时，远程精神病学和面对面治疗之间没有发现显着差异（k = 26，n = 2290；P = 0.248）。对于轻度认知障碍，远程精神病学的全因中断显着少于面对面治疗（k = 1，n = 61；风险比 RR = 0.552，95% CI 0.312–0.975，P = 0.040），而相反的是存在物质滥用（k = 1，n = 85；RR = 37.41，95% CI 2.356–594.1，P = 0.010）。当所有研究/诊断合并时，远程精神病学和面对面治疗之间在全因停药方面没有显着差异（k = 27，n = 3341；P = 0.564）。

远程精神病学对各种精神疾病取得了与面对面治疗类似的症状改善效果。然而，在一些特定的精神疾病中发现了一些优势/劣势，这表明其疗效可能会根据疾病类型而有所不同。