Sir: I wish to report how the advent of new technologies may be influencing the ways in which patients manage their own symptoms.

It recently came to my attention that a husband and wife had devised a method by which they had been able to extend the period of time in which a profoundly agoraphobic patient was able to be independent of their spouse, both inside and outside the home. By both parties of the marriage having a mobile telephone in their possession it allowed, in this case the husband affected with a considerable degree of agoraphobia, to spend considerable periods of time on his own without developing a severe degree of anxiety and fearfulness, with accompanying panic symptoms and an urge to either return home or seek the company of his wife. There is, therefore, an increased degree of security knowing that help is at hand if symptoms recur. An example of this is that he is now able to spend long periods of time fishing, away from the home, an activity he found intolerably stressful previously, as he became acutely concerned if he was not able to return home immediately, or did not have access to a means of transport to do so. Therefore, his anticipatory anxiety has been alleviated by the knowledge that he can contact his wife at any time, leading to a larger social repertoire. He developed a much better sense of control over his circumstances and has broken the cycle of dread of being alone in public places. While there are obviously dangers of dependency occurring because of this, I do feel it allows the patient to have more autonomy.

I am unaware of any other reports of mobile telecommunications being used in this way and it provides a good example of how new technologies may have serendipitous spin-offs for psychiatric patients.