A fully automated conversational agent with artificial intelligence capabilities (Youper) for treating depression and anxiety: A nonrandomized feasibility trial (Preprint)

BACKGROUND Mental health conditions, including depression and anxiety disorders, are significant global concerns. Many people with these conditions don't get the help they need because of the high costs of medical treatment and the stigma attached to seeking help. Digital technologies represent a viable solution to these challenges. However, these technologies are often characterized by relatively low adherence and their effectiveness largely remains empirical unverified. While digital technologies may represent a viable solution for this persisting problem, they often lack empirical support for their effectiveness and are characterized by relatively low adherence. Conversational agents using artificial intelligence capabilities have the potential to offer a cost-effective, low-stigma and engaging way of getting mental health care. OBJECTIVE The objective of this study was to evaluate the feasibility, acceptability, and effectiveness of Youper, a mobile application that utilizes a conversational interface and artificial intelligence capabilities to deliver cognitive behavioral therapy-based interventions to reduce symptoms of depression and anxiety in adults. METHODS 1,012 adults with symptoms of depression and anxiety participated in a real-world setting study, entirely remotely, unguided and with no financial incentives, over an 8-week period. Participants completed digital versions of the 9-item Patient Health Questionnaire (PHQ-9) and the 7-item Generalized Anxiety Disorder scale (GAD-7) at baseline, 2, 4, and 8 weeks. RESULTS After the eight-week study period, depression (PHQ-9) scores of participants decreased by 48% while anxiety (GAD-7) scores decreased by 43%. The RCI was outside 2 standard deviations for 93.0% of the individuals in the PHQ-9 assessment and 90.7% in the GAD-7 assessment. Participants were on average 24.79 years old (SD 7.61) and 77% female. On average, participants interacted with Youper 0.9 (SD 1.56) times per week. CONCLUSIONS Results suggest that Youper is a feasible, acceptable, and effective intervention for adults with depression and anxiety. CLINICALTRIAL Since this study involved a nonclinical population, it wasn't registered in a public trials registry.