It's good to talk - to a computer

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The Independent Online
THE WORLD'S first dial-a-treatment for depression is about to be launched. Depressed patients will be able to dial a special number and talk over the telephone to a computer which will help them find out what is wrong and what needs to be done.

The service, being developed by doctors at the Institute of Psychiatry in London, comes as new research reveals that some patients now prefer talking about their problems to computers rather than a real therapist.

Not only are computers perceived to be more discreet, non- judgemental, quicker, cheaper, and open all hours, with no waiting lists, they may also be better at the job than clinicians. Whereas therapists often make mistakes by not asking all the right questions, the computer unfailingly goes through all the steps every time to rule out other possibilities.

Researchers found that the patients they studied, mostly women, were up to three times more likely to admit to various behaviour patterns to a computer than to their doctor.

"Patients are less embarrassed and more likely to disclose information of a sensitive nature, such as suicide, alcohol or drug abuse, sexual behaviour, or HIV symptoms, to a computer. Some patients, such as those with social phobias and suicide attempters, prefer being interviewed by the computer instead of a clinician," says the report, written by a team from Wisconsin University.

In the dial-a-diagnosis services, patients are given a pin number to connect with the computer over the telephone, and they reply to various questions by using the phone's keypad. The answers given can open up different parts of the program to confirm the computer's diagnosis. The consultation takes around 11 minutes.

"Patients dial a toll-free number, listen to questions read by a computer, and respond. This technology allows a patient to be assessed 24 hours a day, wherever a touch-tone telephone is available," say the research team.

The Institute of Psychiatry in London is now finalising a dial-in service for depression patients. "We do find that some people prefer to talk to computers and with the depression line people will dial in for information from the computer on how to treat themselves," said Dr Richard Parkin, consultant psychiatrist.

"The aim is to get people to think about their behaviour and look at ways to overcome those things. You could phone the system, tell it what you have been doing and it will give you feedback," he continued.

Dr Susan Shaw, clinical lecturer at the institute said: "We are about to introduce - hopefully within the next few months - a computerised clinic called COPE where patients taking part will have a special pin number to get directly into the computer.

"One of the advantages of using a telephone rather than a computer is that 95 per cent of people have access to a phone. The system is also useful for people who don't want a medical record."