Comparison of an AI Chatbot With a Nurse Hotline in Reducing Anxiety and Depression Levels in the General Population: Pilot Randomized Controlled Trial
Open accessAbstract
Background: Artificial intelligence (AI) chatbots have been customized to deliver on-demand support for people with mental health problems. However, the effectiveness of AI chatbots in tackling mental health problems among the general public in Hong Kong remains unclear. Objective: This study aimed to develop a local AI chatbot and compare the effectiveness of the AI chatbot with a conventional nurse hotline in reducing the level of anxiety and depression among individuals in Hong Kong. Methods: This study was a pilot randomized controlled trial conducted from October 2022 to March 2023, involving 124 participants allocated randomly (1:1 ratio) into the AI chatbot and nurse hotline groups. Among these, 62 participants in the AI chatbot group and 41 in the nurse hotline group completed both the pre- and postquestionnaires, including the GAD-7 (Generalized Anxiety Disorder Scale-7), PHQ-9 (Patient Health Questionnaire-9), and satisfaction questionnaire. Comparisons were conducted using independent and paired sample t tests (2-tailed) and the χ2 test to analyze changes in anxiety and depression levels. Results: Compared to the mean baseline score of 5.13 (SD 4.623), the mean postdepression score in the chatbot group was 3.68 (SD 4.397), which was significantly lower (P=.008). Similarly, a reduced anxiety score was also observed after the chatbot test (pre vs post: mean 4.74, SD 4.742 vs mean 3.4, SD 3.748; P=.005), respectively. No significant differences were found in the pre-post scores for either depression (P=.38) or anxiety (P=.19). No statistically significant difference was observed in service satisfaction between the two platforms (P=.32). Conclusions: The AI chatbot was comparable to the traditional nurse hotline in alleviating participants' anxiety and depression after responding to inquiries. Moreover, the AI chatbot has shown potential in alleviating short-term anxiety and depression compared to the nurse hotline. While the AI chatbot presents a promising solution for offering accessible strategies to the public, more extensive randomized controlled studies are necessary to further validate its effectiveness.
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Chen et al reported a differential attrition rate of 34%.
“For instance, Chen et al [50] reported a differential attrition rate of 34% and He et al [54] reported 24 %.”
From Generative AI Mental Health Chatbots as Therapeutic Tools: Systematic Review and Meta-Analysis of Their Role in Reducing Mental Health Issues (2025) · cites this paper as [50]
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- Authors
- Chen, C., Lam, K. T., Yip, K. M., So, H. K., Lum, T. Y. S., Wong, I. C. K., Yam, J. C., Chui, C. S. L., & Ip, P.
- Affiliations
- Queen Mary Hospital (CN)
- University of Hong Kong (HK)
- Macau University of Science and Technology (MO)
- Chinese University of Hong Kong (HK)
- Corresponding author
- Ip, Patrick
- ORCID
- Venue
- JMIR Human Factors
- Publisher
- JMIR Publications Inc.
- Published
- 2025-03-06
- Volume
- 12
- Pages
- e65785-e65785
- ISSN
- 2292-9495 (ISSN-L)
- PMC
- PMC11906115
- OpenAlex
- W4408180360
- Cited by
- 35
- References
- 21
- Citations by year
- 2026: 24 · 2025: 11
- FWCI
- 28.00
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by
- Locations
- JMIR Human Factors (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Aston Publications Explorer (Aston University) (acceptedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Topics
- Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Social Sciences › Psychology › Social Psychology › Social Robot Interaction and HRI
- Keywords
- AI chatbots, anxiety, depression, mental health support, general population, service satisfaction, Hong Kong
- MeSH terms
- Generative Artificial Intelligence, Adult, Anxiety, Artificial Intelligence, Depression, Female, Hong Kong, Humans, Male, Middle Aged, Nurses, Pilot Projects, Surveys and Questionnaires, Hotlines
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