The use of videoconferencing with patients with psychosis: a review of the literature.

Videoconferencing has become an increasingly viable tool in psychiatry, with a growing body of literature on its use with a range of patient populations. A number of factors make it particularly well suited for patients with psychosis. For example, patients living in remote or underserved areas can be seen by a specialist without need for travel. However, the hallmark symptoms of psychotic disorders might lead one to question the feasibility of videoconferencing with these patients. For example, does videoconferencing exacerbate delusions, such as paranoia or delusions of reference? Are acutely psychotic patients willing to be interviewed remotely by videoconferencing? To address these and other issues, we conducted an extensive review of Medline, PsychINFO, and the Telemedicine Information Exchange databases for literature on videoconferencing and psychosis. Findings generally indicated that assessment and treatment via videoconferencing is equivalent to in person and is tolerated and well accepted. There is little evidence that patients with psychosis have difficulty with videoconferencing or experience any exacerbation of symptoms; in fact, there is some evidence to suggest that the distance afforded can be a positive factor. The results of two large clinical trials support the reliability and effectiveness of centralized remote assessment of patients with schizophrenia.

Juvenile offenders' Miranda rights comprehension and self-reported likelihood of offering false confessions.

This study examined whether age, IQ, and history of special education predicted Miranda rights comprehension and the self-reported tendency to falsely confess to a crime among 55 delinquent boys. The Miranda Rights Comprehension Instruments-II, a revised version of Grisso's Instruments for Assessing Understanding and Appreciation of Miranda Rights, were developed for this study and are described in detail in this article. Results revealed that age, IQ, and special education were related to comprehension of Miranda rights. When Miranda comprehension, age, and IQ were simultaneously tested as predictor variables of the self-reported likelihood of false confessions, only age served as an independent predictor. Research and policy implications of this study are presented, and recommendations for use of the original and revised instruments are reviewed.