Effect of a ChatGPT-based digital counseling intervention on anxiety and depression in patients with cancer: A prospective, randomized trial
Abstract
Background Psychological distress is prevalent among newly diagnosed cancer patients, often exacerbating treatment-related anxiety and depression. Artificial intelligence (AI)-driven interventions, such as large language models (LLMs), offer scalable solutions for patient education. However, their effectiveness in mitigating psychological distress in oncology remains unverified.Methods We conducted a prospective, two-center, randomized controlled trial between July and October 2024 to evaluate the effect of a ChatGPT-based digital counseling intervention on anxiety and depression in chemotherapy-naïve cancer patients. Participants were randomized 1:1 to either a ChatGPT-assisted counseling group or a standard clinician-led education group. The primary outcome was the change in Hospital Anxiety and Depression Scale (HADS) scores before the second chemotherapy cycle. Secondary outcomes included patient engagement behavior and the accuracy of AI-generated responses. Multivariable logistic regression assessed independent predictors of anxiety and depression reduction. The trial is registered with ClinicalTrials.gov (NCT06854315).Findings Of 196 screened patients, 160 were randomized (ChatGPT: n = 80; control: n = 80). The final cohort comprised 150 patients (median age: 64 years; 53.3 % female). At follow-up, the ChatGPT group exhibited significantly lower median HADS-Anxiety (6 [0-17] vs. 8 [1-17]; P = 0.002) and HADS-Depression (6 [0-20] vs. 9 [0-19]; P < 0.001) scores compared to controls. ChatGPT use was the strongest predictor of anxiety reduction (OR, 18.684; 95 % CI, 3.981-87.685; P < 0.001). AI responses were deemed appropriate in 88.5 % of cases, with inaccuracies most common in dietary and sexual health recommendations.Interpretation A ChatGPT-based counseling intervention significantly reduced anxiety and depression among newly diagnosed cancer patients prior to chemotherapy. These findings support the potential integration of AI-driven digital tools as adjuncts to conventional oncology education, enhancing patient support and engagement. Further research is needed to refine AI implementation in clinical practice.
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Most studies on generative AI for psychological support have focused on patient populations, and the applicability of these findings to medical trainees remains uncertain.
“Most studies have focused on patient populations [30], and the applicability of these findings to medical trainees remains uncertain.”
Individual studies have investigated ChatGPT-based counseling before chemotherapy.
“ChatGPT-based counseling before chemotherapy”
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- Authors
- Akdogan, O., Uyar, G. C., Yesilbas, E., Baskurt, K., Malkoc, N. A., Ozdemir, N., Yazici, O., Oksuzoglu, B., Uner, A., Ozet, A., & Sutcuoglu, O.
- Affiliations
- Ankara Etlik City Hospital (TR)
- Gazi University (TR)
- ORCID
- Venue
- European Journal of Cancer
- Publisher
- Elsevier BV
- Published
- 2025-05
- Volume
- 221
- Pages
- 115408
- ISSN
- 0959-8049 (ISSN-L)
- OpenAlex
- W4409187918
- Cited by
- 45
- References
- 22
- Citations by year
- 2026: 37 · 2025: 8
- FWCI
- 35.64
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- Locations
- European Journal of Cancer (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
- Health Sciences › Medicine › Oncology › Cancer survivorship and care
- Health Sciences › Medicine › Health Informatics › Artificial Intelligence in Healthcare and Education
- Keywords
- ChatGPT, large language models, anxiety, depression, psychological distress, cancer patients, chemotherapy-naive patients, patient engagement, AI response accuracy, cancer education
- MeSH terms
- Generative Artificial Intelligence, Adult, Aged, Anxiety, Counseling, Depression, Female, Humans, Male, Middle Aged, Neoplasms, Patient Education as Topic, Prospective Studies
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