A new artificial intelligence (AI) study in The New England Journal of Medicine publication NEJM AI demonstrates how an AI chatbot called Therabot can significantly improve symptoms in just two months for those suffering from major depressive disorder (MDD), generalized anxiety disorder (GAD), and eating disorders.
“Generative artificial intelligence (Gen-AI) chatbots hold promise for building highly personalized, effective Mental health treatments at scale, while also addressing user engagement and retention issues common among digital therapeutics,” wrote Dartmouth College’s Geisel School of Medicine senior author Nicholas Jacobson along with Michael Heinz, Daniel Mackin, Brianna Trudeau, Sukanya Bhattacharya, Yinzhou Wang, Haley Banta, Abi Jewett, Abigail Salzhauer, and Tess Griffin.
In this new study, the Dartmouth researchers used a Gen-AI–powered chatbot to provide Mental health treatment in a randomized controlled trial (RCT).
“This is the first RCT demonstrating the effectiveness of a fully Gen-AI therapy chatbot for treating clinical-level Mental health symptoms,” the researchers wrote.
Depression, Anxiety, and Eating Disorders
Depression, also known as major depressive disorder or clinical depression, is a common mental disorder in the United States and globally. An estimated 21 million adult Americans or 8.3% of adults in the United States, experienced a major depressive episode in 2021. An estimated 280 million people worldwide have depression according to the World Health Organization. To put this global figure in context, the current U.S. population is 347 million per the World Population Review, so the estimated total number of people around the world with depression of 280 million is equivalent to roughly 80% of the entire U.S. population.
Generalized anxiety disorder, another common Mental health disorder, affects 6.8 million adult Americans, or 3% of the U.S. populations according to the Anxiety & Depression Association of America. Patients with generalized anxiety disorder have excessive anxiety and worry about multiple events or activities on more days that not for at least six months according to the Diagnostic and Statistical Manual of Mental Disorders, 5th edition, Text Revision (DSM-5-TR).
An estimated 28 million Americans, or 9% of the U.S. population, will have an eating disorder in their lifetime according to a Deloitte Access Economics report. Eating disorders include binge-eating, bulimia nervosa, and anorexia nervosa, which are severe and can be deadly according to the National Institute of Mental health.
Generative AI, AI Chatbots, LLMs
Generative AI, also known as GenAI or GAI, are machine learning models that can produce new content such as text, images, and videos. GenAI chatbots produce human-like content. Examples of GenAI chatbots include OpenAI’s ChatGPT, Google Gemini (formerly Google Bard), Microsoft Copilot, Meta’s Llama 2, Anthropic’s Claude, and xAI’s Grok.
Therabot is an AI chatbot that uses a type of deep learning model called a generative large language model (LLM). ChatGPT, Gemini, Llama2, and Grok are examples of generative AI chatbots with a LLM architecture. Large language models are a class of AI foundation models that were trained on massive amounts of data in order to comprehend and generate content in a human-like manner.
The AI chatbot Therabot is a text-based multi-thread app that is compatible with both iOS and Android smartphones. Therabot was fine-tuned on Mental health conversations created by Mental health experts, including a clinical psychologist and board-certified psychiatrist, who were on the research team. Moreover, the conversations were also peer-reviewed with evidence-based modalities, which consisted mainly of cognitive behavior therapy (CBT), a structured form of talk therapy.
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The Efficacy of Cognitive Behavior Therapy
Cognitive behavior therapy is effective psychological treatment for anxiety, depression, eating disorders, and other mental illnesses.
Cognitive behavior therapy emerged in the 1960s and 1970s as a psychological treatment for major depressive disorder and first-line therapy for many anxiety disorders. The early CBT pioneers include the founder of cognitive therapy Aaron Temkin Beck, MD (1921-2021) and the founder of rational emotive behavior therapy (REBT), psychologist and psychotherapist Albert Ellis (1913-2007).
The core principles of cognitive behavior therapy are that psychological problems are partially based on faulty or unhelpful thinking and behavior, and better ways of coping can be learned. Cognitive behavior treatment typically involves trying to change patterns of unhelpful thinking and behavior in order to alleviate symptoms and improve daily living.
For this study, out of the 210 adult participants with clinically significant symptoms of anxiety, depression, or eating disorders, were randomly divided into two groups, a control group with 104 adults, and an experimental group of 106 adults who underwent Therabot intervention.
“Therabot was well-utilized and received high user ratings,” the Dartmouth researchers reported.
Among the participants who underwent Therabot intervention, the average use was more than six hours during the course of the study period. Moreover, the participants found it comparable to human therapists.
Across the board, participants who used Therabot experienced clinically significant improvements in their symptoms over an eight-week period. Specifically, on average symptoms were decreased by 51% for those diagnosed with depression, 31% for those with general anxiety disorder, and 19% among those diagnosed with eating disorders according to a Dartmouth College release.
“Fine-tuned Gen-AI chatbots offer a feasible approach to delivering personalized Mental health interventions at scale, although further research with larger clinical samples is needed to confirm their effectiveness and generalizability,” the scientists concluded.
Copyright © 2025 Cami Rosso
