title: Transcultural psychiatry made simple--asynchronous telepsychiatry as an approach to providing culturally relevant care.
abstract: OBJECTIVE
  To examine the feasibility and diagnostic reliability of asynchronous telepsychiatry (ATP) consultations in Spanish and ATP consultation with Spanish-to-English translation.
  
  
  METHODS
  Twenty-four interviews of Spanish-speaking patients were videorecorded by a bilingual clinician who also collected patient history data and gave the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I) to each patient. The ATP data (video of the interview and patient history) were forwarded for psychiatric consultation and a diagnostic assessment by the investigators. The ATP data were then examined separately by two Spanish-speaking psychiatrists, before being translated into English and then re-examined by two English-speaking psychiatrists. Agreement between the expert diagnoses of the investigators and the diagnoses from the Spanish consultations, the Spanish-to-English translated consultations, and the SCID-I results was assessed using kappa statistics.
  
  
  RESULTS
  We found acceptable levels of agreement for major diagnostic groupings among the Spanish- and English-speaking psychiatrists. Kappa values for diagnostic agreement between the expert and the translated consultations, the original language consultations, and the SCID-I were at least 0.52 (percentage agreement, 79%) and higher.
  
  
  CONCLUSIONS
  ATP consultations in Spanish, and those translated from Spanish to English, are feasible, and broad diagnostic reliability was achieved. The ATP process allows for rapid language translation. This approach could be useful across national boundaries and in numerous ethnic groups. Cross-language ATP may also offer significant benefits over the use of real-time interpreting services and has the potential to improve the quality of care by allowing for the addition of culturally relevant information.
authors: Department of Psychiatry, University of California-Davis, Sacramento, CA 95817, USA. peter.yellowlees@ucdmc.ucdavis.edu
authors: Peter M
authors: PM
authors: Yellowlees
authors: Alberto
authors: A
authors: Odor
authors: Ana-Maria
authors: AM
authors: Iosif
authors: Michelle Burke
authors: MB
authors: Parish
authors: Najia
authors: N
authors: Nafiz
authors: Kesha
authors: K
authors: Patrice
authors: Glen
authors: G
authors: Xiong
authors: Robert
authors: R
authors: McCaron
authors: Richard
authors: R
authors: Sanchez
authors: Enrique
authors: E
authors: Ochoa
authors: Donald
authors: D
authors: Hilty
mesh_terms: D000328:Adult; D054521:Cultural Competency; D005260:Female; D006630:Hispanic or Latino / Q000523:psychology; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis*; D008875:Middle Aged; D015588:Observer Variation; D011320:Primary Health Care / Q000379:methods*; D011569:Psychiatric Status Rating Scales; D011570:Psychiatry / Q000379:methods*; D012959:Socioeconomic Factors; D017216:Telemedicine / Q000379:methods*