Feasibility of human-in-the-loop multimodal generative artificial intelligence chatbot for school-based adolescent mental health support

doi:10.5498/wjp.123904

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World Journal of Psychiatry

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2220-3206

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World J Psychiatry. Oct 19, 2026; 16(10): 123904
Published online Oct 19, 2026. doi: 10.5498/wjp.123904

Table 1 Characteristics of the study sample (n = 62), stratified by intervention group (n = 30) and waitlist control group (n = 32), mean ± SD or n (%)

Characteristic	Control (n = 32)	Intervention (n = 30)	Overall (n = 62)	P value
Age (year)	13.81 ± 0.59	13.9 ± 0.31	13.86 ± 0.47	0.464
Gender				0.362
Male	12 (37.5)	8 (26.7)	20 (32.3)
Female	20 (62.5)	22 (73.3)	42 (67.7)
Depression symptoms
CES-D	25.53 ± 5.47	34.27 ± 7.42	29.76 ± 7.79	< 0.001^a
PHQ-9	9.88 ± 3.32	14.8 ± 4.06	12.26 ± 4.43	< 0.001^a
Anxiety symptoms
GAD-7	6.91 ± 2.72	11.9 ± 4.28	9.32 ± 4.33	< 0.001^a
Psychological inflexibility
AAQ-II	22.50 ± 6.87	30.37 ± 7.50	26.31 ± 8.15	< 0.001^a
Ruminative thinking
RRS	49.03 ± 10.37	58.63 ± 12.40	53.68 ± 12.29	0.002^a
Emotion regulation
ERI	41.63 ± 10.50	41.43 ± 11.51	41.53 ± 10.91	0.946
Life orientation
LOT-R	11.13 ± 2.25	10.00 ± 2.74	10.58 ± 2.55	0.082
Working alliance (WAI-SR)		3.56 ± 0.86
Bond subscale		3.96 ± 0.92
Task subscale		3.06 ± 0.87
Goal subscale		3.71 ± 1.09
Engagement
Number of messages		325.60 ± 129.71
Total use time (second)		6080.04 ± 2557.09

^aP < 0.01.

A working alliance and engagement were assessed only in the intervention group. CES-D: Center for Epidemiological Studies Depression Scale; PHQ-9: Patient Health Questionnaire-9; GAD-7: Generalized Anxiety Disorder-7; AAQ-II: Acceptance and Action Questionnaire-II; RRS: Rumination Response Scale; ERI: Emotion Regulation Inventory; LOT-R: Life Orientation Test-Revised; WAI-SR: Working Alliance Inventory-Short Revised.

Full Size Table

Citation: Fan XW, Lin TY, Wang MH, Wu LC, Chen XX, Chen JY, Wu YZ, Zheng Y, Li T, Du H, Wang YX, Wang YJ, Zhang JW, Huang LW, Fan TZ, Liu B, Liu J, Sun P, Zhao H, Ma GL, Cheng Q, Li SJ. Feasibility of human-in-the-loop multimodal generative artificial intelligence chatbot for school-based adolescent mental health support. World J Psychiatry 2026; 16(10): 123904
URL: https://www.wjgnet.com/2220-3206/full/v16/i10/123904.htm
DOI: https://dx.doi.org/10.5498/wjp.123904

Fan XW, Lin TY, Wang MH, Wu LC, Chen XX, Chen JY, Wu YZ, Zheng Y, Li T, Du H, Wang YX, Wang YJ, Zhang JW, Huang LW, Fan TZ, Liu B, Liu J, Sun P, Zhao H, Ma GL, Cheng Q, Li SJ. Feasibility of human-in-the-loop multimodal generative artificial intelligence chatbot for school-based adolescent mental health support. World J Psychiatry 2026; 16(10): 123904 [DOI: 10.5498/wjp.123904]

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