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Systematic review and meta analysis of chatbots in the management of depressive and anxiety symptoms
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  • Published: 25 March 2026

Systematic review and meta analysis of chatbots in the management of depressive and anxiety symptoms

  • Jun-Seok Sohn1,
  • Byeong-Gwan Ha2,
  • SoHyun Park3,
  • Jae-Jin Kim4,5,
  • Eojin Lee4,
  • Hyangkyeong Oh4,
  • San Lee6 &
  • …
  • Eunjoo Kim4,5 

npj Digital Medicine , Article number:  (2026) Cite this article

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  • Health care
  • Medical research
  • Psychology

Abstract

Mental health chatbots have proliferated rapidly, yet their effectiveness remains unclear. This systematic review and meta-analysis included randomized controlled trials comparing chatbots with any control condition for depressive and/or anxiety outcomes. PubMed, Embase, PsycINFO, Scopus and Web of Science were searched from January 2017 to October 2025. Risk of bias was assessed using the revised Cochrane tool. Pooled effect sizes (Hedges’ g) were calculated using random-effects models. Of the 39 eligible studies, 38 (n = 7,401) were analyzed for depression and 34 (n = 7,621) for anxiety. Chatbots produced statistically significant reductions in depressive (g = 0.31, 95% CI [0.17, 0.46]) and anxiety symptoms (g = 0.28, 95% CI [0.05, 0.51]) compared with controls. Subgroup analyses for depressive symptoms showed larger effects in clinical and subclinical than in nonclinical samples (p = 0.001). Contemporary chatbots thus appear to alleviate depressive and anxiety symptoms, especially in individuals with greater depressive severity. (PROSPERO registration: CRD42024598761).

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Data availability

The data generated or analyzed during this study are included in this published article and its supplementary information files. Further inquiries can be directed to the corresponding author.

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Acknowledgements

This research was supported by a grant of the Research and Development (R&D) project funded by the National Center for Mental Health (grant number: MHER25C04). The funder had no role in the study design; data collection, analysis, or interpretation; manuscript preparation; or decision to submit the manuscript for publication. We thank Dr. Vincent Kipkorir for feedback on the original draft and methodological insights regarding systematic reviews.

Author information

Authors and Affiliations

  1. Department of Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea

    Jun-Seok Sohn

  2. Department of Psychiatry, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea

    Byeong-Gwan Ha

  3. NAVER Cloud, Seongnam, Republic of Korea

    SoHyun Park

  4. Institute of Behavioral Sciences in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea

    Jae-Jin Kim, Eojin Lee, Hyangkyeong Oh & Eunjoo Kim

  5. Department of Psychiatry, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea

    Jae-Jin Kim & Eunjoo Kim

  6. Working Mind Institute, Seongnam, Republic of Korea

    San Lee

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Contributions

Conceptualization: J.-S.S., H.-K.O., S.L., and E.K.; Methodology: J.-S.S., S.L., and S.P.; Data curation and investigation: J.-S.S., B.-G.H., and E.K.; Writing-original draft: J.-S.S.; Writing-review and editing: J.-S.S., B.-G.H., S.P., J.-J.K., E.L., H.-K.O., S.L., and E.K.; Supervision: J.-J.K., S.L., and E.K.; All authors have read and approved the final manuscript.

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Correspondence to San Lee or Eunjoo Kim.

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Sohn, JS., Ha, BG., Park, S. et al. Systematic review and meta analysis of chatbots in the management of depressive and anxiety symptoms. npj Digit. Med. (2026). https://doi.org/10.1038/s41746-026-02566-w

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  • Received: 08 August 2025

  • Accepted: 09 March 2026

  • Published: 25 March 2026

  • DOI: https://doi.org/10.1038/s41746-026-02566-w

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