不断发展的数字心理健康领域
不断发展的数字心理健康领域：智能手机应用、生成式人工智能和虚拟现实的当前证据和实施问题
The evolving field of digital mental health: current evidence and implementation issues for smartphone apps, generative artificial intelligence, and virtual reality
——《世界精神病学》2025年第24卷第2期——
【摘要】数字心理健康领域不断扩展，正在超越传统的远程医疗，融入智能手机应用程序、虚拟现实和生成式人工智能（包括大型语言模型）。尽管行业挫折和方法论批评凸显了证据方面的差距以及推广这些技术所面临的挑战，但植根于协同设计、严格评估和实施科学的新兴解决方案提供了充满希望的未来发展路径。本文通过五个主题，强调了推进数字心理健康科学基础和提升其实际应用的双重必要性。首先，我们讨论数字表型分析、虚拟现实和生成式人工智能领域的最新技术进展。后者的进展旨在创造对话和图像等新的输出，对心理健康领域具有独特的潜力。鉴于智能手机应用程序的普及，我们随后评估了支持其在各种心理健康领域（包括幸福感、抑郁、焦虑、精神分裂症、饮食失调和物质使用障碍）中效用的证据。对该领域的广泛视角凸显了开展新一代更严谨、安慰剂对照且真实世界研究的必要性。随后，我们探讨了阻碍所有数字心理健康工具应用的参与度挑战，并提出了解决方案，包括人工支持、数字导航、即时自适应干预和个性化方法。之后，我们分析了实施问题，强调了临床医生的参与度、服务整合和可扩展的交付模式。最后，我们回顾了针对历史上边缘化人群和中低收入国家量身定制数字工具的证据，并探讨了确保创新惠及所有人从而弥合数字健康差距的必要性。鉴于数字心理健康创新是增强和扩展护理的工具，我们得出结论：如果部署得当，智能手机应用程序、虚拟现实和大型语言模型可以对心理健康护理产生积极影响。
【关键词】数字心理健康、智能手机应用程序、虚拟现实、生成人工智能、大型语言模型、参与度、实施科学、抑郁症、焦虑症、精神分裂症、饮食失调、物质使用障碍
[Abstract] The expanding domain of digital mental health is transitioning beyond traditional telehealth to incorporate smartphone apps, virtual reality, and generative artificial intelligence, including large language models. While industry setbacks and methodological critiques have highlighted gaps in evidence and challenges in scaling these technologies, emerging solutions rooted in co-design, rigorous evaluation, and implementation science offer promising pathways forward. This paper underscores the dual necessity of advancing the scientific foundations of digital mental health and increasing its real-world applicability through five themes. First, we discuss recent technological advances in digital phenotyping, virtual reality, and generative artificial intelligence. Progress in this latter area, specifically designed to create new outputs such as conversations and images, holds unique potential for the mental health field. Given the spread of smartphone apps, we then evaluate the evidence supporting their utility across various mental health contexts, including well-being, depression, anxiety, schizophrenia, eating disorders, and substance use disorders. This broad view of the field highlights the need for a new generation of more rigorous, placebo-controlled, and real-world studies. We subsequently explore engagement challenges that hamper all digital mental health tools, and propose solutions, including human support, digital navigators, just-in-time adaptive interventions, and personalized approaches. We then analyze implementation issues, emphasizing clinician engagement, service integration, and scalable delivery models. We finally consider the need to ensure that innovations work for all people and thus can bridge digital health disparities, reviewing the evidence on tailoring digital tools for historically marginalized populations and low- and middle-income countries. Regarding digital mental health innovations as tools to augment and extend care, we conclude that smartphone apps, virtual reality, and large language models can positively impact mental health care if deployed correctly.
[Key words] Digital mental health, smartphone apps, virtual reality, generative artificial intelligence, large language models, engagement, implementation science, depression, anxiety, schizophrenia, eating disorders, substance use disorders
论文原文：John Torous, Jake Linardon, Simon B. Goldberg, et al (2025). The evolving field of digital mental health: current evidence and implementation issues for smartphone apps, generative artificial intelligence, and virtual reality. World Psychiatry, Volume 24, Issue 2, Pages 156-174. June 2025.
https://doi.org/10.1002/wps.21299
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