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Randomized Controlled Trial
. 2025 Mar 6:12:e65785.
doi: 10.2196/65785.

Comparison of an AI Chatbot With a Nurse Hotline in Reducing Anxiety and Depression Levels in the General Population: Pilot Randomized Controlled Trial

Chen Chen  1 , Kok Tai Lam  1 , Ka Man Yip  1 , Hung Kwan So  1 , Terry Yat Sang Lum  2 , Ian Chi Kei Wong  3   4   5 , Jason C Yam  6 , Celine Sze Ling Chui  7 , Patrick Ip  1
Affiliations
Randomized Controlled Trial

Comparison of an AI Chatbot With a Nurse Hotline in Reducing Anxiety and Depression Levels in the General Population: Pilot Randomized Controlled Trial

Chen Chen et al. JMIR Hum Factors. .

Abstract

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.

Keywords: AI chatbot; anxiety; artificial intelligence; depression; effectiveness.

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Conflict of interest statement

Conflicts of Interest: None declared.

Figures

Figure 1.
Figure 1.. Diagram of the study design. AI: artificial intelligence. PHQ-9: Patient Health Questionnaire-9; GAD-7: Generalized Anxiety Disorder Scale-7.
Figure 2.
Figure 2.. Comparison of anxiety and depression scores within groups pre- and postintervention. GAD-7: Generalized Anxiety Disorder Scale-7; PHQ-9: Patient Health Questionnaire-9; ns: nonsignificant. **P<.05.
See this image and copyright information in PMC

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