Conversational Agent Interventions for Mental Health Problems: Systematic Review and Meta-analysis of Randomized Controlled Trials

Journal of Medical Internet Research, Год журнала: 2023, Номер 25, С. e43862 - e43862

Опубликована: Март 10, 2023

Mental health problems are a crucial global public concern. Owing to their cost-effectiveness and accessibility, conversational agent interventions (CAIs) promising in the field of mental care.

Язык: Английский

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Transforming mental health systems globally: principles and policy recommendations

The Lancet, Год журнала: 2023, Номер 402(10402), С. 656 - 666

Опубликована: Авг. 1, 2023

Язык: Английский

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Digital transformation of mental health services

npj Mental Health Research, Год журнала: 2023, Номер 2(1)

Опубликована: Авг. 22, 2023

Abstract This paper makes a case for digital mental health and provides insights into how technologies can enhance (but not replace) existing services. We describe by presenting suite of (from interventions to the application artificial intelligence). discuss benefits health, example, intervention be an accessible stepping-stone receiving support. The does, however, present less-discussed with new concepts such as ‘poly-digital’, where many different apps/features (e.g. sleep app, mood logging app mindfulness etc.) each address factors wellbeing, perhaps resulting in aggregation marginal gains. Another benefit is that offers ability collect high-resolution real-world client data provide monitoring outside therapy sessions. These collected using phenotyping ecological momentary assessment techniques (i.e. repeated or scale measures via app). allows tools inform therapists enrich face-to-face referred blended care/adjunctive service users engage ‘channel switching’ between non-digital (face-to-face) providing more integrated service. integration kind ‘digital glue’ helps join up in-person sessions real world. presents challenges, majority apps are maybe inadequate quality there lack user retention. There also ethical perceived ‘over-promotion’ screen-time reduction care when replacing humans ‘computers’, trap ‘technological solutionism’ whereby technology naively presumed solve all problems. Finally, we argue need take evidence-based, systems thinking co-production approach form stakeholder-centred design developing services based on technologies. main contribution this ideas from disciplines well framework showcase physical emergence ‘poly-digital’ discussion challenges specifically ethics’.

Язык: Английский

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Current evidence on the efficacy of mental health smartphone apps for symptoms of depression and anxiety. A meta‐analysis of 176 randomized controlled trials

World Psychiatry, Год журнала: 2024, Номер 23(1), С. 139 - 149

Опубликована: Янв. 12, 2024

The mental health care available for depression and anxiety has recently undergone a major technological revolution, with growing interest towards the potential of smartphone apps as scalable tool to treat these conditions. Since last comprehensive meta‐analysis in 2019 established positive yet variable effects on depressive symptoms, more than 100 new randomized controlled trials (RCTs) have been carried out. We conducted an updated objectives providing precise estimates effects, quantifying generalizability from this evidence base, understanding whether app trial characteristics moderate effect sizes. included 176 RCTs that aimed or symptoms. Apps had overall significant although small symptoms (N=33,567, g=0.28, p<0.001; number needed treat, NNT=11.5) generalized (N=22,394, g=0.26, p<0.001, NNT=12.4) compared control groups. These were robust at different follow‐ups after removing sample higher risk bias trials. There was less variability outcome scores post‐test conditions (ratio variance, RoV=–0.14, 95% CI: –0.24 –0.05 symptoms; RoV=–0.21, –0.31 –0.12 symptoms). Effect sizes significantly larger when incorporated cognitive behavioral therapy (CBT) features chatbot technology. primary target administered CBT mood monitoring features. found social (g=0.52) obsessive‐compulsive (g=0.51) post‐traumatic stress (g=0.12), large acrophobia (g=0.90), non‐significant negative panic (g=–0.12), results should be considered caution, because most high based conclude but anxiety, specific – such technology are associated

Язык: Английский

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Canadian Network for Mood and Anxiety Treatments (CANMAT) 2023 Update on Clinical Guidelines for Management of Major Depressive Disorder in Adults: Réseau canadien pour les traitements de l'humeur et de l'anxiété (CANMAT) 2023 : Mise à jour des lignes directrices cliniques pour la prise en charge du trouble dépressif majeur chez les adultes

The Canadian Journal of Psychiatry, Год журнала: 2024, Номер 69(9), С. 641 - 687

Опубликована: Май 6, 2024

Background The Canadian Network for Mood and Anxiety Treatments (CANMAT) last published clinical guidelines the management of major depressive disorder (MDD) in 2016. Owing to advances field, an update was needed incorporate new evidence provide revised recommendations assessment MDD adults. Methods CANMAT convened a editorial group comprised academic clinicians patient partners. A systematic literature review conducted, focusing on reviews meta-analyses since 2016 guidelines. Recommendations were organized by lines treatment, which informed CANMAT-defined levels supplemented support (consisting expert consensus safety, tolerability, feasibility). Drafts based partners, peer review, defined process. Results updated comprise eight primary topics, question-and-answer format, that map care journey from selection evidence-based treatments, prevention recurrence, strategies inadequate response. adopt personalized approach emphasizes shared decision-making reflects values, preferences, treatment history with MDD. Tables psychological, pharmacological, lifestyle, complementary alternative medicine, digital health, neuromodulation treatments. Caveats limitations are highlighted. Conclusions 2023 evidence-informed MDD, clinician-friendly format. These emphasize collaborative, personalized, will help optimize outcomes adults

Язык: Английский

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