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The Effectiveness of AI Chatbots in Alleviating Mental Distress and Promoting Health Behaviors Among Adolescents and Young Adults: Systematic Review and Meta-Analysis

Feng X, Tian L, Ho GWK, Yorke J, Hui V

Journal of medical Internet research, 2025

29,637 participants · 22 citations

Abstract

Background: The prevalence of mental distress and health risk behaviors among adolescents and young adults has emerged as a pressing public health concern. Artificial intelligence (AI) chatbots have been increasingly recognized for their potential to provide scalable and accessible mental health support and health education; however, questions remain about their effectiveness in addressing the unique challenges faced by adolescents and young adults.

Objective: This study aimed to synthesize evidence from randomized controlled trials (RCTs) on the effectiveness of AI chatbots in alleviating mental distress and promoting health behaviors among adolescents and young adults.

Methods: Eight databases (PubMed, PsycINFO, Cochrane Library, CINAHL, Embase, Web of Science, Scopus, and IEEE Xplore) were searched for RCTs published in English between January 1, 2014, and January 26, 2025. Eligible studies assessed the effects of AI chatbots on mental distress and health behavior outcomes among adolescents and young adults (15-39 years). Extracted data were synthesized narratively or meta-analyzed as appropriate; subgroup and meta-regression analyses were performed to explore moderators of chatbot effectiveness. Risk of bias was evaluated using the revised Cochrane risk-of-bias 2 (RoB 2) tool for randomized trials. Evidence quality was evaluated using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach.

Results: Out of 2495 records retrieved, 31 RCTs…

How strong is the evidence?

Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 29,637 participants or records.

How the five levels of evidence work. The level is assigned automatically from the abstract and can be wrong, so check the paper.

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