Conversational Agent Interventions for Mental Health Problems: Systematic Review and Meta-analysis of Randomized Controlled Trials.
Conversational Agent Interventions for Mental Health Problems: Systematic Review and Meta-analysis of Randomized Controlled Trials.
复制标题
心理健康问题的对话代理干预：随机对照试验的系统回顾和荟萃分析。
DOI：
10.2196/43862
复制
发表时间：
2023-04-28
影响因子：
7.4
通讯作者：
Hou, Xiangqing
中科院分区：
文献类型：
--
作者：
He, Yuhao;Yang, Li;Qian, Chunlian;Li, Tong;Su, Zhengyuan;Zhang, Qiang;Hou, Xiangqing
关键词：
心理健康问题是一个重要的全球公共卫生问题。由于其成本效益和可获得性，对话式代理干预(CAI)在精神卫生保健领域很有前途。本研究旨在通过随机对照试验的Meta分析，全面总结一系列心理健康问题的CAI的特点，寻找有效性的证据，并分析有统计学意义的有效性调节因素。系统检索网络数据库(EMBASE、MEDLINE、PEYCINFO、CINAHL、WEB of Science和Cochrane)，时间从数据库建立至2021年10月30日，更新至2022年5月1日。将CAIS与任何其他类型的控制条件在改善抑郁症状、全身性焦虑症状、特殊焦虑症状、生活质量或幸福感、一般痛苦、压力、精神障碍症状、心身疾病症状以及积极和消极情绪方面进行比较的随机对照试验被认为是合格的。这项研究遵循PRISMA(系统回顾和荟萃分析的首选报告项目)指南。数据由两个独立的评价者提取，由第三个评价者核对，并使用随机效应模型和固定效应模型进行合并。选择对冲g作为效应大小。在6900项确定的记录中，总共纳入了32项研究，涉及6089名参与者。在改善抑郁症状(g=0.29，95%CI 0.20~0.38)、一般焦虑症状(g=0.29，95%CI 0.21~0.36)、特殊焦虑症状(g=0.47，95%CI 0.07~0.86)、生活质量或幸福感(g=0.27，95%CI 0.16~0.39)、一般苦恼(g=0.33，95%CI 0.20~0.45)、压力(g=0.24，精神障碍症状(g=0.36，95%CI 0.17~0.54)、心身疾病症状(g=0.62，95%CI 0.14~1.11)、负性情感(g=0.28，95%CI 0.05~0.51)。然而，CAI对大多数精神健康结果的长期影响并不具有统计学意义(g=−0.04~0.39)。个人化和共情反应是影响疗效的两个关键因素。与会话代理交互的持续时间越长，合并效应的大小越大。研究结果表明，CAI是经过研究证实的干预措施，应该在精神卫生保健中更广泛地实施。对于有精神健康问题的人来说，CAI是有效的，很容易被接受。这一新型数字技术的临床应用将节省人类卫生资源，优化精神卫生服务配置。PROSPERO CRD42022350130；https://tinyurl.com/mvhk6w9p
Mental health problems are a crucial global public health concern. Owing to their cost-effectiveness and accessibility, conversational agent interventions (CAIs) are promising in the field of mental health care. This study aims to present a thorough summary of the traits of CAIs available for a range of mental health problems, find evidence of efficacy, and analyze the statistically significant moderators of efficacy via a meta-analysis of randomized controlled trial. Web-based databases (Embase, MEDLINE, PsycINFO, CINAHL, Web of Science, and Cochrane) were systematically searched dated from the establishment of the database to October 30, 2021, and updated to May 1, 2022. Randomized controlled trials comparing CAIs with any other type of control condition in improving depressive symptoms, generalized anxiety symptoms, specific anxiety symptoms, quality of life or well-being, general distress, stress, mental disorder symptoms, psychosomatic disease symptoms, and positive and negative affect were considered eligible. This study followed the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Data were extracted by 2 independent reviewers, checked by a third reviewer, and pooled using both random effect models and fixed effects models. Hedges g was chosen as the effect size. Of the 6900 identified records, a total of 32 studies were included, involving 6089 participants. CAIs showed statistically significant short-term effects compared with control conditions in improving depressive symptoms (g=0.29, 95% CI 0.20-0.38), generalized anxiety symptoms (g=0.29, 95% CI 0.21-0.36), specific anxiety symptoms (g=0.47, 95% CI 0.07-0.86), quality of life or well-being (g=0.27, 95% CI 0.16-0.39), general distress (g=0.33, 95% CI 0.20-0.45), stress (g=0.24, 95% CI 0.08-0.41), mental disorder symptoms (g=0.36, 95% CI 0.17-0.54), psychosomatic disease symptoms (g=0.62, 95% CI 0.14-1.11), and negative affect (g=0.28, 95% CI 0.05-0.51). However, the long-term effects of CAIs for the most mental health outcomes were not statistically significant (g=−0.04 to 0.39). Personalization and empathic response were 2 critical facilitators of efficacy. The longer duration of interaction with conversational agents was associated with the larger pooled effect sizes. The findings show that CAIs are research-proven interventions that ought to be implemented more widely in mental health care. CAIs are effective and easily acceptable for those with mental health problems. The clinical application of this novel digital technology will conserve human health resources and optimize the allocation of mental health services. PROSPERO CRD42022350130; https://tinyurl.com/mvhk6w9p
登录
查看更多内容
DOI：
10.1016/j.jadohealth.2022.02.023
发表时间：
2022-06
期刊：
The Journal of adolescent health : official publication of the Society for Adolescent Medicine
影响因子：
--
作者：
Adams SH;Schaub JP;Nagata JM;Park MJ;Brindis CD;Irwin CE Jr
通讯作者：
Irwin CE Jr
影响因子：
1.7
作者：
Cartreine, James Albert;Locke, Steven E.;Hegel, Mark T.
通讯作者：
Hegel, Mark T.
影响因子：
4.1
作者：
Fairburn, Christopher G.;Patel, Vikram
通讯作者：
Patel, Vikram
影响因子：
1.9
作者：
Duval, S;Tweedie, R
通讯作者：
Tweedie, R
影响因子：
1.8
作者：
Gaffney, Hannah;Mansell, Warren;Wright, Jason
通讯作者：
Wright, Jason