Conversational agent interventions may be helpful in mental health care

1. In this systematic review and meta-analysis, conversational agent interventions (CAIs) were associated with improvements in several mental health symptoms, such as stress, anxiety, and depression, in the short term.

2. In addition, longer interaction times with the CAIs produced larger effect sizes with respect to mental health outcomes.

Evidence Rating Level: 1 (Excellent)

Conversational agent interventions (CAIs) are a form of artificial intelligence developed to meet the demand for more mental health services. Previous studies investigating the effectiveness of CAIs have yielded mixed results. Thus, the potential effectiveness of CAIs in addressing the global burden of mental health is not well understood. As a result, the objective of the present study was to review the utility of CAIs in addressing mental health problems.

Of 6900 identified records, 32 (n=6089 participants) studies were included from various databases from database inception to May 2022. Studies were included if they were randomized controlled trials that compared the effects of CAIs versus controls on mental health outcomes. Studies were excluded if they focused on physical health or user experience, rather than mental health outcomes. The review was performed using PRISMA guidelines. Quality assessment was performed using the Cochrane Collaboration tool. The primary outcome was the impact of CAIs on various mental health outcomes (e.g., symptoms of depression, anxiety, stress, psychosomatic symptoms, etc.).

The results demonstrated that, compared to controls, CAIs were superior in improving symptoms of depression, generalized anxiety, stress, negative affect, and psychosomatic disease. In addition, longer interaction times with CAIs produced larger pooled effect sizes. Despite these findings, the study was limited by the fact that different studies used different measurement tools for the same mental health outcomes, which may have affected the magnitude of the results. Nonetheless, the present study added important evidence to suggest that CAIs may have clinical utility in improving mental health outcomes.

Click to read the study in Journal of Medical Internet Research

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