Investigating text-messaging psychiatric disorders consultations on the telemedicine platform Haodaifu online in China: topic modelling and content analysis

Despite the high prevalence of mental disorders in China, consultation rates remain low. Public stigma leads many people to turn to computer-mediated consultation platforms. There is a pressing need to examine the topics of online psychiatric consultations to provide targeted education and interventions. This study analyzed online psychiatric consultations on Haodaifu Online (‘Good Doctor Online’) in China, focusing on psychiatrists’ speech during patient interactions. First, we extracted data from the platform and applied topic modeling to identify key topics and terms. We then analyzed these topics qualitatively using thematic synthesis. A total of 7,029 consultation cases met our inclusion criteria, and the psychiatrists’ speech from these cases was used for modeling. We identified nine topics, categorized into six themes: suggested timing and lifestyle changes; medication dose adjustments; causes of psychiatric disorders; initial inquiries about patients’ conditions; mental disorders in children and adolescents; and recommendations for face-to-face consultations. The themes reflect patients’ concerns during online psychiatric counseling. Psychiatrists treated online consultations as preliminary medical visits and still recommended in-person consultations for formal diagnosis and treatment.