Anxiety and Depression Chatbot Features: A Scoping Review (Preprint)

BACKGROUND Apps and web-based chatbots can provide valuable and meaningful support to healthcare workers in assessing and guiding management of various health problems particularly when human resources are scarce. Despite poor adherence to such apps, chatbots can be cost-effective and efficient on-demand virtual assistants for various mental health conditions, including anxiety and depression. OBJECTIVE This study aims to review the features of chatbots currently available for individuals with suspected anxiety or depression. METHODS ACM digital library, IEEE, Google Scholar, Embase, Medline, and PsychINFO were the six bibliographic databases searched for conducting the review. We conducted backward and forward reference list checking of included studies. Study selection and data extraction were performed by two reviewers independently; two other individual reviewers justified cross-checking of extracted data. We utilized a narrative approach for synthesizing the data. RESULTS The initial search returned a total of 917 citations. A total of 32 studies remained on filtering the publications, which formed the final dataset for this scoping review. While most of the studies were from conference proceedings (69%, n=22), the remainder were either journal articles (16%, n=5), reports (9%, n=3), or book chapters (6%, n=2). Of the studies that developed an actual chatbot, 16% (n=7) were web based and 63% (n=20) stand-alone in the form of an app. The remainder were available on both platforms or were only conceptual ideas. About half of the reviewed chatbots had functionality targeting both anxiety and depression (56%, n=18), whereas 38% (n=12) targeted only depression, 3% (n=1) anxiety and the remaining addressed other mental health issues along with anxiety and depression like public speaking anxiety, stress, lack of motivation, negative emotion, nervousness. Input modality of most of the chatbots was written (84%, n=27), followed by spoken (25%, n=8) and visual imaging (9%, n=3). Despite the fact of increasing popularity of embodiment techniques in chatbots such as avatars were rarely used in these studies only 34% (n=11) CONCLUSIONS Recent research shows that mental health chatbots could be of benefit in helping patients with anxiety and depression and provide valuable support to mental healthcare workers, particularly when resources are scarce. They often provide virtual assistance where medical professionals are inaccessible or users need anonymous real-time personal virtual assistance. Their role in mental health care is expected to increase following the COVID-19 pandemic and its impact on mental health and wellbeing of the world population.