{
  "abstract": "Background: Major depressive disorder is a leading cause of disability, and access to specialist psychiatric follow-up remains limited in many settings. Telepsychiatry may reduce logistical barriers to care, but data on video-based follow-up under routine outpatient conditions in Türkiye are scarce, and comparisons of delivery modalities are frequently limited by baseline imbalance between self-selected groups.\n\nObjective: The aim of the study is to describe symptom trajectories and attendance over 6 months of routine psychiatric follow-up delivered either face-to-face or online and to examine whether outcomes differed between modalities after adjustment for baseline severity.\n\nMethods: In this prospective, nonrandomized observational cohort study, 120 adults with Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) major depressive disorder were followed for 6 months at a university hospital psychiatry department in Ankara, Türkiye (September 2021 to May 2022). Participants entered face-to-face (n=60) or online (n=60) follow-up according to their own preference. Seven sessions were scheduled at approximately 4-week intervals; the Hamilton Depression Rating Scale (HAM-D; primary outcome), the Hamilton Anxiety Rating Scale, and DSM-5 Level 1 and Level 2 measures were administered at baseline and at sessions 1, 2, 4, and 6. Attendance was recorded at all sessions. Between-group comparisons used analysis of covariance adjusted for the corresponding baseline score and for prespecified covariates. Linear mixed models incorporating a group-by-time interaction were fitted to all available observations, and multiple imputation (m=20) was performed as a sensitivity analysis.\n\nResults: Depressive symptoms decreased substantially in both groups: mean HAM-D fell from 26.6 to 5.0 in the face-to-face group (81.2% reduction; Cohen d=4.86; P<.001; n=43) and from 24.1 to 3.3 in the online group (86.3% reduction; Cohen d=6.06; P<.001; n=49). Response rates were 41 of 43 (95.3%) and 48 of 49 (98%; P=.60), and remission rates were 32 of 43 (74.4%) and 43 of 49 (87.8%; P=.11). Unadjusted between-group differences at sessions 4 and 6 did not persist after adjustment for baseline severity (session 4: –0.47, 95% CI –1.71 to 0.77; P=.46; session 6: –0.79, 95% CI –2.22 to 0.65; P=.28), and the group-by-time interaction was not significant (χ23=1.9; P=.59). Anxiety scores did not differ at any time point. Findings were unchanged under multiple imputation, and prescribing patterns were comparable. Attendance across all 7 scheduled sessions was higher in the online group overall (373/420, 88.8% vs 319/420, 76%; P<.001), with differences at sessions 2 through 5.\n\nConclusions: Both modalities were followed by large reductions in depressive symptoms, and between-group differences did not persist after adjustment for baseline severity. The study was not designed as an equivalence trial and cannot establish equivalence. The most consistent difference favoring online follow-up was attendance, although its reasons could not be determined. These findings characterize online psychiatric follow-up as a feasible means of maintaining continuity of routine care rather than as a more effective one.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Psychiatry Afyonkarahisar State Hospital Afyonkarahisar Türkiye",
    "Department of Psychiatry Faculty of Medicine Ankara University Ankara Türkiye"
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 2,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Doğan Akalın",
      "orcid": "0000-0002-3028-7511"
    },
    {
      "affs": [
        1
      ],
      "name": "Vesile Şentürk Cankorur",
      "orcid": "0000-0002-2911-8323"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/34ddb9hbrhxcc.bib",
  "cited_by": 0,
  "doi": "10.2196/97656",
  "fulltext_url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC13728771/",
  "id": "34ddb9hbrhxcc",
  "issns": [
    "2561-326X"
  ],
  "landing_url": "https://doi.org/10.2196/97656",
  "language": "en",
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Original Paper"
    ],
    [
      "openalex",
      "2739|Telemedicine and Telehealth Implementation"
    ]
  ],
  "openalex": "W7222925596",
  "pdf_url": null,
  "pmcid": "PMC13728771",
  "pmid": "42896175",
  "published": "2026-10-19",
  "publisher": "JMIR Publications Inc.",
  "ris": "https://research.draconitic.com/paper/34ddb9hbrhxcc.ris",
  "sources": [
    {
      "first_seen": "2026-11-07T12:21:41Z",
      "native_id": "PMC13728771",
      "source": "pmc",
      "url": "https://doi.org/10.2196/97656"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2739|Telemedicine and Telehealth Implementation",
      "subfield": "epidemiology-public-health"
    }
  ],
  "title": "Symptom Trajectories and Attendance in Face-to-Face and Online Psychiatric Follow-Up for Major Depressive Disorder and Anxiety Symptoms: Prospective Observational Cohort Study",
  "title_text": "Symptom Trajectories and Attendance in Face-to-Face and Online Psychiatric Follow-Up for Major Depressive Disorder and Anxiety Symptoms: Prospective Observational Cohort Study",
  "type": "peer-reviewed",
  "updated_at": "2026-11-07T12:21:41Z",
  "url": "https://research.draconitic.com/paper/34ddb9hbrhxcc",
  "venue": "JMIR Formative Research",
  "versions": []
}