JMIR Publications

ABSTRACT

Background:

Youper is a widely used, commercially available mobile app that uses Artificial Intelligence (AI) Therapy for the treatment of anxiety and depression.

Objective:

The present study examined the feasibility, 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.

Methods:

We examined data from paying Youper users (N = 4517) who allowed their data to be used for research. To characterize the feasibility and acceptability of Youper, we asked users to rate the app on a five-star scale and measured retention statistics for users’ first four 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.

Results:

Users of Youper rated the app highly (M = 4.36 out of 5 stars, SD = .84) and 43% of users were retained by week four. Symptoms decreased in the first two weeks of app use (anxiety: d = .57, depression: d = .46). Anxiety improvements were maintained in the subsequent two weeks, but depression symptoms increased slightly with a very small effect size (d = .05). A higher proportion of successful emotion regulation attempts significantly predicted greater anxiety and depression symptom reduction.

Conclusions:

Youper is a low-cost, completely self-guided treatment that is accessible to users who may not otherwise access mental health care. Our findings demonstrate feasibility, acceptability, and effectiveness of Youper as a treatment for anxiety and depression symptoms.