title: Psychological online consultation service attracts men: a new approach to close the gap between being ill and being treated.
abstract: BACKGROUND
  Since 1999, the University Hospital Zurich (Zurich, Switzerland) has offered an e-mail-based consultation service for individual health concerns where anonymous questions can be asked to an online doctor. This study aimed at the characterization of the user profile, the content of the question, and the answers given specific in the field of psychiatry.
  
  
  METHODS
  In total, 3,148 questions were asked from 2008 to 2010. Of these, 209 (6.6%) requests were selected by International Classification of Diseases-10 and International Classification of Primary Care codes relevant for psychiatry and included in the retrospective qualitative study. The content analysis of the requests was supported by means of the Mayring inductive category system using a professional text analysis program (MAXQDA).
  
  
  RESULTS
  Of the users, 45.9% were female, and 46.9% were male. The mean age was 37.4 years. The main topics of the request were somatoform, somatization, and hypochondriac disorders in 18.4%, behavioral syndromes in 17.9%, and mood disorders in 15.4%. The reason stated most frequently for using the service was looking for a second opinion. The doctors responded with detailed information about disease and treatment and in 70.8% recommended consultation of a physician.
  
  
  CONCLUSIONS
  Telemedicine is suggested to empower patients by developing health literacy with professional advice. The gender ratio of the users is almost equal, although the prevalence of psychological diseases in the general population is higher in women than in men. Psychological online consultation may potentially reach mentally ill individuals who do not have or did not seek professional help yet, and it seems to be especially attractive for men.
authors.affiliation: 1 Clinical Telemedicine, University Hospital Zurich , Zurich, Switzerland .
authors.forename: Sabine
authors.initials: S
authors.lastname: Schmidt-Weitmann
authors.forename: Sarah
authors.initials: S
authors.lastname: Bösch
authors.forename: Steffi
authors.initials: S
authors.lastname: Weidt
authors.forename: Christiane
authors.initials: C
authors.lastname: Brockes
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000523:psychology / Q000628:therapy*; D008875:Middle Aged; D010353:Patient Education as Topic / Q000379:methods; D017060:Patient Satisfaction; D019114:Remote Consultation / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D057545:Social Stigma; D013557:Switzerland
keywords: e-health; telecommunications; telemedicine; telepsychiatry