Development and Evaluation of HopeBot: an LLM-based chatbot for structured and interactive PHQ-9 depression screening

Abstract: Static tools like the Patient Health Questionnaire-9 (PHQ-9) effectively screen depression but lack interactivity and adaptability. We developed HopeBot, a chatbot powered by a LLM that administers the PHQ-9 using retrieval-augmented generation and real-time clarification. In a within-subject study, 132 adults in the United Kingdom and China completed both self-administered and chatbot versions. Scores demonstrated strong agreement (ICC = 0.91; 45% identical). Among 75 participants providing comparative feedback, 71% reported greater trust in the chatbot, highlighting clearer structure, interpretive guidance, and a supportive tone. Mean ratings (0-10) were 8.4 for comfort, 7.7 for voice clarity, 7.6 for handling sensitive topics, and 7.4 for recommendation helpfulness; the latter varied significantly by employment status and prior mental-health service use (p < 0.05). Overall, 87.1% expressed willingness to reuse or recommend HopeBot. These findings demonstrate voice-based LLM chatbots can feasibly serve as scalable, low-burden adjuncts for routine depression screening.