Aug 2026· Healthcare· Vol 14, pp. 2334· 0 citations· 35 references
Medicine
TL;DR
AI-guided CBT represents a promising but still evolving component of modern mental health care and has the potential to improve accessibility, optimize resource allocation, and support stepped-care and hybrid models of treatment.
Abstract
Background: Depression and anxiety disorders remain among the leading contributors to global disability and represent a major public health challenge. Although evidence-based psychotherapies are available, access to treatment remains limited due to structural, economic, geographical, and workforce-related barriers. Digital mental health interventions have emerged as scalable approaches to reducing this treatment gap, with artificial intelligence (AI)-guided cognitive behavioral therapy (CBT) representing a rapidly developing and clinically relevant extension of digital psychotherapy. Objective: This review aims to synthesize current evidence on digital and AI-guided CBT interventions for depression and anxiety, with a focus on clinical utility, scalability, mechanisms of change, safety considerations, and public health relevance. In addition, the review proposes a clinically oriented conceptual framework for understanding the role of AI-guided CBT within contemporary digital psychiatry. Methods: A focused narrative review was conducted using PubMed, Scopus, and Google Scholar databases, covering publications from 2010 to 2025. Relevant peer-reviewed studies, systematic reviews, meta-analyses, and conceptual papers addressing digital CBT, AI-assisted CBT, conversational agents, symptom monitoring, and digital mental health implementation were identified and analyzed qualitatively. Results: Existing evidence suggests that internet-delivered CBT, mobile applications, and AI-based conversational agents may reduce depressive and anxiety symptoms, particularly in individuals with mild to moderate conditions. However, the evidence base remains heterogeneous, with limitations including short follow-up periods, variability in intervention quality, reliance on self-reported outcomes, and insufficient data on long-term effectiveness, safety, and real-world implementation. Emerging concepts such as digital therapeutic alliance, continuous symptom monitoring, adaptive intervention delivery, and AI-driven personalization may represent key factors influencing engagement and clinical outcomes. Conclusions: AI-guided CBT represents a promising but still evolving component of modern mental health care. These technologies have the potential to improve accessibility, optimize resource allocation, and support stepped-care and hybrid models of treatment. Future research should prioritize rigorous clinical validation, long-term outcome evaluation, transparent safety protocols, ethical governance, and integration into real-world health systems. AI-guided CBT should not be understood as a replacement for clinicians, but as a complementary and scalable extension of evidence-based psychotherapy.
The review underscores the need for longitudinal research, refined diagnostic frameworks, and context-sensitive implementation strategies to advance holistic, patient-centered management of depression in schizophrenia.
Oshi Malik, Priyanka Yadav· Indian Journal of Medical Sp...· 0 citations
Abstract “Brain health” encompasses key functions such as cognition, emotion, and behaviour, and is increasingly relevant given its role across neurological and psychiatric conditions. One of these, depression is the most common psychiatric comorbidity in people with epilepsy (PWE). When unrecognized and untreated, depression is associated with increased seizure severity and poorer treatment response, significantly impacting patients’ prognosis and quality of life; conversely, the rate of epilepsy is 2-fold higher in individuals with incident depression compared to those without depression. Several studies have confirmed a strong bidirectional relationship between epilepsy and depression; an advisory panel of psychiatrists and neurologists with expertise in epilepsy and mood disorders convened for a virtual meeting held in 2024 to assess the impact of the interplay between these two conditions. A comprehensive, interdisciplinary approach to discussion was adopted to address challenges in diagnosing and managing depression in PWE, focusing on early intervention, patient education, and tailored treatments strategies; additionally, the meeting emphasized the importance of integrated care between neurologists and psychiatrists to address this unmet medical need. The authors identified depression in PWE as being underdiagnosed due to overlapping symptoms, stigma, and limited psychiatric care integration. Management is challenging as some antiseizure medication worsen depression and certain antidepressants may lower the seizure threshold, requiring careful selection and monitoring to balance efficacy and safety. Potential interactions between these medicines underscore the importance of carefully selecting therapeutic combinations to minimize adverse effects. Effective management involves an interdisciplinary approach, integrating neurologists and psychiatrists. Key strategies include early screening, psychoeducation, a personalized approach to pharmacological and nonpharmacological treatment, and increased awareness among healthcare providers, patients, and caregivers regarding the overlap of neurological and psychiatric disorders. Furthermore, educational resources, as well as digital tools, can help inform and educate patients and caregivers on holistic brain health management.
P. Brambilla, R. Kälviäinen, Bettina Schmitz et al.· Neuropsychiatric Disease and...· 0 citations
Depression is a prevalent condition manifested by prolonged sadness, functional impairment and an increased risk of relapse. Relapse prevention remains a primary concern for clinicians. Cognitive Behavioural Therapy (CBT) is widely recognized as an evidence-based treatment; thereby research is needed to comprehend its overall impact on depressive symptoms. The aim of this review was to analyze the effectiveness of Cognitive Behavioral Therapy (CBT) compared to Treatment as Usual (TAU) in preventing depressive relapse amongst the adult population. A systematic search was conducted on electronic databases like PubMed and Cochrane library, along with register Clinicaltrials.gov and other sources, for studies published between 2010 and 2025. Nine randomized controlled trials were selected with sufficient data to perform meta-analysis. Covidence was used for data extraction, while Cochrane Risk of Bias Tool (RoB 2) for evaluating study quality. The results showed no significant difference, and the effect size was negligible (Hedges' g = 0.068). Subgroup and meta-regression analyses evaluated that the outcome of CBT was not influenced by the number of CBT sessions or the duration of the follow-up. However, the severity of depression did have some degree of influence. From the evidence currently available, there is no indication that CBT is superior to TAU in preventing depressive relapse in adults. Future studies with longer follow-up periods and defined CBT frameworks are needed to better grasp the long-term effectiveness of CBT.
Introduction: Adolescent depression is characterized by severe clinical symptoms and executive dysfunction, but the multi-scale therapeutic mechanisms of non-pharmacological psychological interventions remain disputed. Objective: To systematically evaluate the regulation and remodeling effects of psychological interventions on clinical symptoms, higher cognitive functions, neurocircuits, and peripheral biological mechanisms in depressed adolescents. Method: Following PRISMA guidelines, we searched PubMed, Web of Science, and Cochrane Library (to June 2026). Literature screening, data extraction, and quality assessment (PEDro/MINORS scales) were performed independently. Results: Seventeen high-quality studies were included. (1) Combined psychological and pharmacological interventions accelerated acute symptom relief, reduced rumination and suicidal ideation, and restored social functioning. (2) Interventions enhanced executive control, shortened reaction times (Stroop/WCST/TMT), and improved working memory and verbal fluency. (3) Neuroimaging/EEG revealed synergistic limbic pathology reversal and prefrontal compensatory remodeling under cognitive tasks. (4) Interventions suppressed HPA axis hyperactivity, decreased interleukin-6 levels, and activated the BDNF pathway, facilitating bidirectional peripheral-central cross-talk. Conclusions: Combined psychological and pharmacological therapy effectively improves clinical symptoms and cognitive deficits in adolescents. Brain network remodeling operates via a dual-track synergistic model of limbic normalization and prefrontal compensation, proving evidence-based psychotherapy is a non-pharmacological prescription driving neuroplasticity.
Zhongming Zhao, Mufan Zhang, Yuping Zou et al.· STUDIES IN HEALTH SCIENCES· 0 citations
Social anxiety disorder (SAD) is a common and often persistent mental health condition that typically emerges during adolescence and is associated with marked functional impairment. Although cognitive-behavioral therapy and selective serotonin reuptake inhibitors remain first-line treatments, many individuals experience incomplete response, poor tolerability, stigma-related concerns, or limited access to care. Against this background, exercise has attracted increasing interest as a low-cost, accessible, and scalable adjunctive intervention, although adherence and accessibility may vary across populations. In this mini-review, we synthesize current evidence on the role of physical activity and structured exercise in the management of SAD. Available findings suggest that higher levels of physical activity are generally associated with lower social anxiety symptoms, while emerging intervention studies indicate that aerobic exercise, climbing, and group-based exercise programs may confer psychological benefit. Exercise may complement mainstream therapies through partially overlapping yet distinct pathways, including enhancement of self-efficacy, resilience, body image, and social engagement, as well as modulation of cognitive bias, neuroplasticity, and stress-related physiological processes. Potential applications in adolescents, individuals with autism spectrum disorder and comorbid social anxiety, and performance-related anxiety contexts also warrant attention. However, the current evidence base remains limited by small samples, heterogeneous interventions, insufficient long-term follow-up, and a lack of large randomized controlled trials in clinically diagnosed SAD, and much of the available evidence derives from non-clinical or subclinical populations. Overall, exercise should be considered a promising adjunct rather than a replacement for established treatments, and future research should prioritize mechanism-informed, precision-based, and implementation-oriented intervention models.
L. Lele, Yang Xin, Yong-gwan Song· Frontiers in Psychology· 0 citations
Adolescence represents a critical developmental period marked by heightened vulnerability to internalizing disorders, specifically anxiety and depression. Left unaddressed, these conditions significantly impair educational attainment, social relationships, and long-term functional trajectories. School nurses occupy a unique, strategically advantageous position within the educational ecosystem, serving as accessible healthcare providers capable of bridging the gap between undetected psychological distress and evidence-based mental health support. This review synthesizes existing literature surrounding school-based mental health nursing interventions focused on the early identification and management of anxiety and depression among adolescents.Utilizing an integrative mapping approach, we synthesized evidence from primary studies published between 2012 and 2026. The findings illustrate that nurse-led interventions—primarily encompassing brief Cognitive-behavioral Therapy (CBT) modules, structured psychoeducation, mindfulness-based emotion regulation techniques, and universal screening protocols demonstrate significant efficacy in reducing symptom severity and mitigating physical manifestations of distress, such as somatic complaints.
