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Digital Health Reviews (3938) Digital Mental Health Interventions, e-Mental Health and Cyberpsychology (3428) Anxiety and Stress Disorders (1674) Chatbots and Conversational Agents (1262) Clinical Mental Health Informatics (161)

Published on in Vol 27 (2025)

Preprints (earlier versions) of this paper are available at https://preprints.jmir.org/preprint/78238, first published .
Man looking at smartphone with AI chatbot conversation bubbles

Generative AI Mental Health Chatbots as Therapeutic Tools: Systematic Review and Meta-Analysis of Their Role in Reducing Mental Health Issues

Generative AI Mental Health Chatbots as Therapeutic Tools: Systematic Review and Meta-Analysis of Their Role in Reducing Mental Health Issues

Authors of this article:

Qiyang Zhang1 Author Orcid Image ;   Renwen Zhang2 Author Orcid Image ;   Yiying Xiong3 Author Orcid Image ;   Yuan Sui3 Author Orcid Image ;   Chang Tong3 Author Orcid Image ;   Fu-Hung Lin3 Author Orcid Image
Article Authors Cited by (68) Tweetations (4) Metrics

Journals

  1. Zhang Q, Zhang R, Xiong Y, Sui Y, Tong C, Lin F. Generative AI Mental Health Chatbots as Therapeutic Tools: Systematic Review and Meta-Analysis of Their Role in Reducing Mental Health Issues. Journal of Medical Internet Research 2025;27:e78238 View
  2. Chung V, Bernier P, Hudon A. Mass Media Narratives of Psychiatric Adverse Events Associated With Generative AI Chatbots: Rapid Scoping Review. JMIR Mental Health 2026;13:e93040 View
  3. Chen S, Feucht M, Bhatt A, Farlow J. Artificial Intelligence in Head and Neck Surgical Oncology: A State-of-the-Art Review. Journal of Clinical Medicine 2026;15(7):2767 View
  4. Kéri S. Szimulált tudat, álempátia és kötődésillúzió: mit kezdhet a pszichiátria a mesterséges intelligenciával?. Orvosi Hetilap 2026;167(14):539 View
  5. Shoshani A, Gurfinkel B, Kor A, Ben-Haim Y, Kanarek O, Segev R, Shafir O, Arbel R. Efficacy of a Conversational AI Agent for Psychiatric Symptoms and Digital Therapeutic Alliance. JAMA Network Open 2026;9(4):e266713 View
  6. Schmidt R, Gonzalez S, St. George S, DiCamillo C, Horigian V. Shedding light on mental health problems and potential solutions for young women: results from an anonymous asynchronous online focus group. Frontiers in Psychiatry 2026;17 View
  7. Coulombe É, Hudon A, Paquin V. The Therapeutic Potential of Chatbots for Men Who Are Involuntarily Single: A Commentary on Lafortune et al. (2026). Archives of Sexual Behavior 2026 View
  8. Lialiou P, Katsiroumpa A, Gallos P, Konstantakopoulou O, Moisoglou I, Galani O, Tsiachri M, Galanis P. Exploring Nurses’ Perspectives on the Use of Artificial Intelligence Chatbots for Mental Health Support: A Cross-Sectional Study in Greece. Nursing Reports 2026;16(4):133 View
  9. Basantes Insuasti J, Corrales Vargas D, Villa Yánez V. Inteligencia Artificial Generativa como apoyo para la personalización de intervenciones terapéuticas para la depresión: una revisión exploratoria. Esprint Investigación 2026;5(1):754 View
  10. Yang M, Oka M, Mori H. Development and Evaluation of a Chatbot-Based System for Early Detection of Depression Indicators. Computers 2026;15(5):269 View
  11. Wei H, Atwal P, Humphrey L, Yu Y. Evaluating the safety of AI responses in suicide-related interactions: A clinically informed framework and simulation study. Psychiatry Research Communications 2026;6(2):100263 View
  12. Jaewon L. From Adolescence to Older Adulthood: Lifespan Pathways Linking AI Companion Chatbots to Mental Health. Lifespan Development and Mental Health 2026;2(1):10005 View
  13. Xiong Y, Zhai Y, Fulmer R. Regulating Artificial Intelligence in Mental Health: A Content Analysis of Global Professional Ethical and Policy Guidelines. Journal of Counseling & Development 2026;104(3):339 View
  14. Hoffman L, Hoffman L. Artificial Intelligence and Being Human: Critical Thinking, Creativity, and Empathy. The Journal of Humanistic Counseling 2026;65(3):211 View
  15. Novebri N, Kurniady D, Komariah A, Sianturi R, Kadarsah D, Tamam B, Kusumadewi R, Darmawan D, Akil A, Hadiyanto H. AI-Integrated Counseling Administration Quality and Organizational Support as Drivers of Early Risk Detection in Indonesian Schools. F1000Research 2026;15:585 View
  16. Santos B, Roza T, Passos I. The engagement-validation loop: Sycophancy, anthropomorphic projection, and clinical risk in informal AI-based mental health support. Journal of Affective Disorders 2026;412:122123 View
  17. Suffoletto B, Preiksaitis C, Kim D, Rose C, Pitre V, Pillai N, Mandal M. AI counseling agent for motivational interviewing: Conversational processes associated with change talk in emergency department patients. Journal of Substance Use and Addiction Treatment 2026;190:210053 View
  18. García-Viola A, Márquez-Hernández V, Garrido-Molina J, Alcayde-García A, Rodríguez-García M. Design, Development, and Validation of a Chatbot to Support Health Care Professionals Experiencing Workplace Aggression: Protocol for a Mixed Methods Study. JMIR Research Protocols 2026;15:e92511 View
  19. Zhong L, Zhou C, Miao J, Dong J, Luo L, Liu C, Li Y. Transforming surgical ward rounds: constructivist pedagogy, structured models, and intelligent technologies. Frontiers in Medicine 2026;13 View
  20. Xue K, Tuzovic S, Gottlieb U. Reimagining Therapy: Consumer Perceptions of Generative AI in Mental Health. Journal of Consumer Affairs 2026;60(3) View
  21. Fong T, Chan C, Kwok A, Chan R, Tang R, Wen M, Yip P. Relationship Between Generative AI Use and Life Satisfaction and the Mediating Role of AI Literacy Among Hong Kong Adults: Cross-Sectional Study. Journal of Medical Internet Research 2026;28:e88362 View
  22. El Hajj S, Nsouli A, Wehbe M, Saad G, Maalouf F. From promise to practice: artificial intelligence in mental health care in the MENA region. Frontiers in Psychiatry 2026;17 View
  23. Morgado P. Artificial intelligence in psychiatry: clinical applications, limitations, and ethical challenges. Frontiers in Behavioral Neuroscience 2026;20 View
  24. Li Q. Research on a painting art therapy auxiliary support model based on Mel frequency cepstral coefficient deep feature decoupling and emotion-adaptive instance normalization. Systems and Soft Computing 2026;9:200567 View
  25. Kaneda Y. When patients consult artificial intelligence before clinicians: restoring clinical prioritisation in mental health care. The British Journal of Psychiatry 2026:1 View
  26. Winiger F, Smith C, Nourriz S, Szilagyi C, Haußmann A. Artificial Intelligence in Spiritual Care: Modified Delphi Study. Journal of Medical Internet Research 2026;28:e97094 View
  27. Diel A, Torous J, Cuijpers P, Kleesiek J, Nensa F, Weber N, Faust F, Lalgi T, Mellis F, Teufel M, Bäuerle A. A scoping review on the mental health harms of LLM-based chatbots. npj Digital Medicine 2026;9(1) View
  28. Høgsdal H, Kyrrestad H, Kaiser S. Generative AI in Youth Mental Health Apps: Rapid Review. JMIR Mental Health 2026;13:e90589 View
  29. Shi H, Zhang T, Wang Z, Yang X, Shao Z, Ma X. Latent profiles of generative artificial intelligence use among Chinese college students: Associations with depression and anxiety. Journal of Affective Disorders 2026;415:122428 View
  30. Mahat-Shamir M, Payes M, Kagan M. Perceived Support Is Not Psychological Change: Reframing AI Chatbots in Mental Health Care. JMIR AI 2026;5:e94503 View
  31. Meng Y, Que Y, Yan Z, Liu B, Wang Z, Yang M, Lu H. Personalized Intelligent Chatbot Based on AI-Generated Content Assists Memoir Writing for Older Adults With Cognitive Impairment: Mixed Methods Study. JMIR Human Factors 2026;13:e83428 View
  32. Lastretti M, Manchia M, Fraschini M, Faa A, Coghe F, Paribello P, Pinna M, Tiwari E, Suri J, Saba L, Rugge M, Isayeva U, Cicoli A, Campedelli L, D’Aleo E, Faa G. Emotional Reliance on Artificial Intelligence: A Scoping Review of AI Companionship and Mental Health Implications. Psychiatry International 2026;7(5):194 View
  33. Kagizman S, Yazla E, Aydinoglu U, Kizilaslan O, Tunckal M, Kahraman Y. Quality of Gambling Disorder Information Generated by Large Language Model Chatbots: A Multidimensional Evaluation. Journal of Technology in Behavioral Science 2026 View
  34. Hassan L, Khalaf O, Jaber R, Mostafa R. The Future of Psychosocial Healthcare Research: Integrating Artificial Intelligence, Equity Science, Behavioral Medicine, and Human-Centered Care. International Journal of Social and Psychological Aspects of Healthcare 2026;6(2):220 View
  35. Zhang Q, Zhang R, Liu N. How AI companions could deepen social inequality. Nature Human Behaviour 2026;10(9):1622 View
  36. Hlynsson J, Vernmark K, Lutovsky C, Andersson G, Carlbring P. Patient experience and psychologists' attitudes toward AI in psychological treatment: A topic-modeling study. Internet Interventions 2026;46:100999 View
  37. Guarini M. When Machines Make Humans Feel: Emotion, Intelligence, and the Ethics of AI. Journal of Superintelligence 2026;1(2):6 View
  38. Mohamed N. Strengthening mental health care in Somalia through artificial intelligence: opportunities, challenges, and a roadmap for implementation. Frontiers in Digital Health 2026;8 View
  39. Latif M, Li G, Wang J, Shahzad M. Does Social Support from Persona-Driven Chatbots Encourage Continued Help-Seeking? The Role of Emotional Relief in Online Mental Health Communities. International Journal of Human–Computer Interaction 2026:1 View
  40. Rostami P, Bakhtiari E, Baharizadeh B, Grasso G. A Hybrid AI-Assisted Framework for Anxiety Support: System Description and Exploratory Findings Among University Students. Behavioral Sciences 2026;16(10):1781 View
  41. Palka A, Kopyciński W, Krawczyk N, Wilczkowski P, Krzysztofek N, Kamela M, Boszczyk K, Grzybowska M, Baran A, Krawczyk O. ARTIFICIAL INTELLIGENCE IN PSYCHIATRIC DIAGNOSIS AND CLINICAL DECISION-MAKING: CURRENT EVIDENCE, CLINICAL APPLICATIONS, CHALLENGES AND FUTURE DIRECTIONS. International Journal of Innovative Technologies in Social Science 2026;5(3(51)) View
  42. Łapot M, Hober K, Krupnik D, Skowron W, Skowron M, Bzdak W, Szwemińska P, Górak J, Neumann W. LARGE LANGUAGE MODEL–BASED CHATBOTS IN MENTAL HEALTH SUPPORT: A NARRATIVE REVIEW OF OPPORTUNITIES, RISKS, AND ETHICAL CHALLENGES. International Journal of Innovative Technologies in Social Science 2026;5(3(51)) View
  43. Shao C, Chen X, Qiao S, Li A, Liu S, Chen Y. Efficacy of artificial intelligence-driven conversational agents (chatbots) for mental health promotion among university students: a systematic review and meta-analysis. Frontiers in Psychiatry 2026;17 View
  44. Fan X, Lin T, Wang M, Wu L, Chen X, Chen J, Wu Y, Zheng Y, Li T, Du H, Wang Y, Wang Y, Zhang J, Huang L, Fan T, Liu B, Liu J, Sun P, Zhao H, Ma G, Cheng Q, Li S. Feasibility of human-in-the-loop multimodal generative artificial intelligence chatbot for school-based adolescent mental health support. World Journal of Psychiatry 2026;16(10) View
  45. Zhou C, Kang W. Multimodal data processing for affective perception in AI-supported developmental bibliotherapy: a mixed-methods feasibility study in university libraries. Frontiers in Psychology 2026;17 View
  46. Xiao W, Cao X, Jin W, Chen X, Cai J, Luo X, Deng J. Psychological support for depression and anxiety across chronic illness contexts: a comparative evaluation of three general-purpose AI chatbots. Frontiers in Psychiatry 2026;17 View
  47. Shen Z, Shi S, Mao L, Li C, Xie J. Mapping Technologies, Support Functions, Evaluation Outcomes, and Safety Governance Related to Conversational AI Agents for Psychological Support of Patients With Cancer: Scoping Review. Journal of Medical Internet Research 2026;28:e105599 View
  48. Chung D, Zhang Z, Wang J. Emotional Engagement with AI Chatbots and Subjective Well-Being Among Young Adults: Extending the S–O–R Model Through Psychological Mechanisms. Behavioral Sciences 2026;16(11):1983 View
  49. Qiu N, Xu D, Sahakian B, Langley C, Eils R, Marciano L, Montag C, Halpern J, Yeo B, Yip P, Yao D, Becker B. The Future of Artificial Intelligence and Emerging Technologies in Mental Health: Prospects, Challenges, and a Roadmap for Personalized Treatment. Psychotherapy and Psychosomatics 2026:1 View
  50. Rahman J, Kabir M. EvoRiri: Interpretable Evolutionary Search for Diagnosing Reward Design Failures in a Bangla Mental Health Assistant. Mathematics 2026;14(21):3982 View
  51. Hopkins A, Modi N, Rowland A, Schultz T, Gradon K, Battersby M, Menz B. Sycophancy and Extended Engagement with Publicly Accessible Generative AI: Aligning Deployment with Mental Health Needs. Current Psychiatry Reports 2026;28(1) View
  52. Jaroszewski A, Jonathan G, Jones G, Patel A, Jacoby R, Wilhelm S. Randomized controlled trials evaluating generative artificial intelligence-enabled mental health interventions among samples with clinically significant baseline symptoms: a systematic review and narrative synthesis. Clinical Psychology Review 2026:102814 View
  53. Wang D, Li Z, Shi H, Jin H. I’d Rather Talk to AI About Work Stress: Extending the O-S-R-O-R Model Through Human-AI Communication in Workplace Health Contexts. Health Communication 2026:1 View
  54. Panayi P, Berry K, Parnami A, Branitsky A, Jidong D. An Updated Systematic Review and Meta‐Synthesis of Service User's Experiences of Cognitive Behavioural Therapy for Psychosis (CBTp). Clinical Psychology & Psychotherapy 2026;33(6) View
  55. Lee L, Yuen W. Minds, machines, and medicine: AI technologies across health domains. Current Opinion in Psychology 2027;74:102495 View
  56. Santos B, Dolberth A, De Toni G, Dantas C, de Lima Ruffini M, Kapczinski F, Hallak J, Passos I, Roza T. Generative AI chatbots and mental health: A critical narrative review of benefits, risks, and clinical implications. Psychiatry and Clinical Neurosciences 2026 View

Books/Policy Documents

  1. . Selbstentwicklung und Coaching mit KI: Dein Prompt-Kompass für Klarheit und Wandel. View
  2. Warnett U, Sureephong P, Chernbumroong S, Duangnamol T. Information Retrieval and Knowledge Management. View
  3. Jouhar R, Ahmed M, Halim M, Niazi F, Vohra F. Integrating Oral and General Health Epidemiology Through Data Science and AI. View
  4. Vu X. Emotion Regulation - Theory, Practice, and Application [Working Title]. View

Conference Proceedings

  1. Wang C, Zhang J, Zhou C. Proceedings of the Extended Abstracts of the 2026 CHI Conference on Human Factors in Computing Systems. Who Is More Willing to Form a Romantic Intimate Relationship with GAI? View
  2. N M, A M, K M. 2026 6th International Conference on Expert Clouds and Applications (ICOECA). Senti Bot: An AI-Driven Emotional Support and Crisis Intervention System using Multimodal Interaction View
  3. N S, K M, John Baskar S, S D. 2026 6th International Conference on Pervasive Computing and Social Networking (ICPCSN). EMO-GUIDE: Emotion-Driven Interactive Chatbot for Mental Well-Being using FSM-based Dialogue Control View
  4. Rekkas P, Verbert K, Vanden Abeele V. Proceedings of the 8th ACM Conference on Conversational User Interfaces. Design and Evaluation of ChatBlend: A Framework and Card Deck for the Human-Centered Design of Mental Health Chatbots in Blended Care View
  5. Sulaiman D, Vatresia A, Anggriani K. 2026 International Conference on Information Technology and Computing (ICITCOM). Hybrid IndoBERT-QWEN3 Architecture for Context-Aware Indonesian Mental Health Dialogue System View
  6. Agarwal S. 2026 IEEE 13th International Conference on Intelligent Systems (IS). Large Language Models in Mental Health Support and Psychotherapy Chatbots: Clinical Applications, Evidence Base, Ethical Risks, and Governance Priorities View
  7. Peng X, Aminna , Liang D, Liu R, Zhang R, Li H. Proceedings of the 2026 2nd International Conference on Big Data and Intelligent Medicine. A Preliminary Study on Dual-Dimensional Mental Health Support with Informal Supporter Empowerment View
  8. Kamita T, Inoue T. 2026 Collaborative Technologies and Data Science for Smart Cities Applications (CODASSCA). Generative-AI-Assisted Image Selection Support for Self-Guided Mental Healthcare View