Artificial Intelligence-Based Chatbot for Anxiety and Depression in University Students: Pilot Randomized Controlled Trial

Maria Carolina Klos; Milagros Escoredo; Angela Joerin; Viviana Noemí Lemos; Michiel Rauws; Eduardo L Bunge

doi:10.2196/20678

Artificial Intelligence-Based Chatbot for Anxiety and Depression in University Students: Pilot Randomized Controlled Trial

JMIR Form Res. 2021 Aug 12;5(8):e20678. doi: 10.2196/20678.

Authors

Maria Carolina Klos^#¹, Milagros Escoredo^#², Angela Joerin^#², Viviana Noemí Lemos^#¹, Michiel Rauws^#², Eduardo L Bunge^#³

Affiliations

¹ Interdisciplinary Center for Research in Health and Behavioral Sciences (CIICSAC), Universidad Adventista del Plata (UAP)., National Scientific and Technical Research Council (CONICET)., Libertador San Martín, Entre Ríos, Argentina.
² X2AI inc., San Francisco, CA, United States.
³ Department of Psychology, Palo Alto University, Palo Alto, CA, United States.

^# Contributed equally.

PMID: 34092548
PMCID: PMC8391753
DOI: 10.2196/20678

Abstract

Background: Artificial intelligence-based chatbots are emerging as instruments of psychological intervention; however, no relevant studies have been reported in Latin America.

Objective: The objective of the present study was to evaluate the viability, acceptability, and potential impact of using Tess, a chatbot, for examining symptoms of depression and anxiety in university students.

Methods: This was a pilot randomized controlled trial. The experimental condition used Tess for 8 weeks, and the control condition was assigned to a psychoeducation book on depression. Comparisons were conducted using Mann-Whitney U and Wilcoxon tests for depressive symptoms, and independent and paired sample t tests to analyze anxiety symptoms.

Results: The initial sample consisted of 181 Argentinian college students (158, 87.2% female) aged 18 to 33. Data at week 8 were provided by 39 out of the 99 (39%) participants in the experimental condition and 34 out of the 82 (41%) in the control group. On an average, 472 (SD 249.52) messages were exchanged, with 116 (SD 73.87) of the messages sent from the users in response to Tess. A higher number of messages exchanged with Tess was associated with positive feedback (F_2,36=4.37; P=.02). No significant differences between the experimental and control groups were found from the baseline to week 8 for depressive and anxiety symptoms. However, significant intragroup differences demonstrated that the experimental group showed a significant decrease in anxiety symptoms; no such differences were observed for the control group. Further, no significant intragroup differences were found for depressive symptoms.

Conclusions: The students spent a considerable amount of time exchanging messages with Tess and positive feedback was associated with a higher number of messages exchanged. The initial results show promising evidence for the usability and acceptability of Tess in the Argentinian population. Research on chatbots is still in its initial stages and further research is needed.

Keywords: anxiety; artificial intelligence; chatbots; college students; conversational agents; depression; mental health.

©Maria Carolina Klos, Milagros Escoredo, Angela Joerin, Viviana Noemí Lemos, Michiel Rauws, Eduardo L Bunge. Originally published in JMIR Formative Research (https://formative.jmir.org), 12.08.2021.