Observational studyJournal of medical Internet research2021
Acceptability and Effectiveness of Artificial Intelligence Therapy for Anxiety and Depression (Youper): Longitudinal Observational Study.
Observational study in Journal of medical Internet research, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 38 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
38 citing papers in PubMed, 112 citations in OpenAlex.
- GymBuddy and Elomia, AI-integrated applications, effects on the mental health of the students with psychological disorders.BMC psychology · 2025Trial
- A scoping review on the mental health harms of LLM-based chatbots.NPJ digital medicine · 2026Article
- Real-World Engagement With a Generative AI Conversational Agent for Mental Health Support: Retrospective Descriptive Study.JMIR formative research · 2026Article
- Supporting Student Mental Health With the Safespace Generative AI Chatbot: Mixed Methods Feasibility Study.JMIR formative research · 2026Article
- Current Landscape of Mental Health Conversational Agents From a Trauma-Informed Care Lens: Scoping Review.JMIR mental health · 2026Article
- Neuropsychological Mechanisms Associated with the Effectiveness of AI-Delivered Health Promotion Programs: A Comprehensive Meta-Analysis.Brain sciences · 2026Review
- Supporting Mental Health with Apps: A Systematic Review of Potential and Quality of Implemented Behavior Change Techniques in Mobile Health Applications.European journal of investigation in health, psychology and education · 2026Review
- Predicting adherence to fully-automated, chatbot-delivered digital cognitive behavioral therapy for insomnia (dCBT-I) using machine learning: A pilot real-world study.PLOS digital health · 2026Article
- Examining the Potential of Social Robots to Increase Adherence in Internet-based CBT.International journal of social robotics · 2026Article
- Clinical Efficacy, Therapeutic Mechanisms, and Implementation Features of Cognitive Behavioral Therapy-Based Chatbots for Depression and Anxiety: Narrative Review.JMIR mental health · 2025Review
- A Prompt Engineering Framework for Large Language Model-Based Mental Health Chatbots: Conceptual Framework.JMIR mental health · 2025Article
- The role of prompt, voice, and personality factors in the acceptance and evaluation of AI-generated mindfulness exercises.Scientific reports · 2025Article
- The hope and the hype of artificial intelligence for syncope management.European heart journal. Digital health · 2025Article
- The Mental Health Impacts of Internet Scams.International journal of environmental research and public health · 2025Review
- Artificial Intelligence-Based Mobile Phone Apps for Child Mental Health: Comprehensive Review and Content Analysis.JMIR mHealth and uHealth · 2025Review
- Depression Self-Care Apps' Characteristics and Applicability to Older Adults: Systematic Assessment.Journal of medical Internet research · 2025Article
- When can AI psychotherapy be considered comparable to human psychotherapy? Exploring the criteria.Frontiers in psychiatry · 2025Article
- Artificial Intelligence-Powered Cognitive Behavioral Therapy Chatbots, a Systematic Review.Iranian journal of psychiatry · 2025Review
- Exploring user characteristics, motives, and expectations and the therapeutic alliance in the mental health conversational AI Clare®: a baseline study.Frontiers in digital health · 2025Article
- Emotionally adaptive support: a narrative review of affective computing for mental health.Frontiers in digital health · 2025Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundYouper is a widely used, commercially available mobile app that uses artificial intelligence therapy for the treatment of anxiety and depression.
objectiveOur study examined the acceptability and effectiveness of Youper. Further, we tested the cumulative regulation hypothesis, which posits that cumulative emotion regulation successes with repeated intervention engagement will predict longer-term anxiety and depression symptom reduction.
methodsWe examined data from paying Youper users (N=4517) who allowed their data to be used for research. To characterize the acceptability of Youper, we asked users to rate the app on a 5-star scale and measured retention statistics for users' first 4 weeks of subscription. To examine effectiveness, we examined longitudinal measures of anxiety and depression symptoms. To test the cumulative regulation hypothesis, we used the proportion of successful emotion regulation attempts to predict symptom reduction.
resultsYouper users rated the app highly (mean 4.36 stars, SD 0.84), and 42.66% (1927/4517) of users were retained by week 4. Symptoms decreased in the first 2 weeks of app use (anxiety: d=0.57; depression: d=0.46). Anxiety improvements were maintained in the subsequent 2 weeks, but depression symptoms increased slightly with a very small effect size (d=0.05). A higher proportion of successful emotion regulation attempts significantly predicted greater anxiety and depression symptom reduction.
conclusionsYouper is a low-cost, completely self-guided treatment that is accessible to users who may not otherwise access mental health care. Our findings demonstrate the acceptability and effectiveness of Youper as a treatment for anxiety and depression symptoms and support continued study of Youper in a randomized clinical trial.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.