不斷發展的數字心理健康領域：智能手機應用、生成式人工智能和虛擬現實的當前證據和實施問題

The evolving field of digital mental health: current evidence and implementation issues for smartphone apps, generative artificial intelligence, and virtual reality

——《世界精神病學》2025年第24卷第2期——

Volume 24, Issue 2, 2025

【摘要】數字心理健康領域不斷擴展，正在超越傳統的遠程醫療，融入智能手機應用程序、虛擬現實和生成式人工智能（包括大型語言模型）。儘管行業挫折和方法論批評凸顯了證據方面的差距以及推廣這些技術所面臨的挑戰，但植根於協同設計、嚴格評估和實施科學的新興解決方案提供了充滿希望的未來發展路徑。本文通過五個主題，強調了推進數字心理健康科學基礎和提升其實際應用的雙重必要性。首先，我們討論數字表型分析、虛擬現實和生成式人工智能領域的最新技術進展。後者的進展旨在創造對話和圖像等新的輸出，對心理健康領域具有獨特的潛力。鑑於智能手機應用程序的普及，我們隨後評估了支持其在各種心理健康領域（包括幸福感、抑鬱、焦慮、精神分裂症、飲食失調和物質使用障礙）中效用的證據。對該領域的廣泛視角凸顯了開展新一代更嚴謹、安慰劑對照且真實世界研究的必要性。隨後，我們探討了阻礙所有數字心理健康工具應用的參與度挑戰，並提出了解決方案，包括人工支持、數字導航、即時自適應干預和個性化方法。之後，我們分析了實施問題，強調了臨床醫生的參與度、服務整合和可擴展的交付模式。最後，我們回顧了針對歷史上邊緣化人群和中低收入國家量身定製數字工具的證據，並探討了確保創新惠及所有人從而彌合數字健康差距的必要性。鑑於數字心理健康創新是增強和擴展護理的工具，我們得出結論：如果部署得當，智能手機應用程序、虛擬現實和大型語言模型可以對心理健康護理產生積極影響。

【關鍵詞】數字心理健康、智能手機應用程序、虛擬現實、生成人工智能、大型語言模型、參與度、實施科學、抑鬱症、焦慮症、精神分裂症、飲食失調、物質使用障礙

[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

論文原文：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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