S1831 Artificial Intelligence-Enabled Virtual Reality Support Tool in Patients With Inflammatory Bowel Disease and Mild-to-Moderate Anxiety Is Feasible and Reduces Anxiety and Pain

Introduction: Anxiety is prevalent in patients with Crohn’s disease (CD) and ulcerative colitis (UC). Cognitive behavioral therapy (CBT) is an evidence-based intervention for anxiety, but access to this and other psychotherapies is limited. We investigated the feasibility of an artificial intelligence (AI)-supported conversational avatar within a virtual reality (VR) environment to deliver mental health support to patients with CD or UC and mild-to-moderate anxiety. Methods: The eXtended-reality Artificial Intelligence Assistant (XAIA, Cedars-Sinai, Los Angeles), a previously developed AI-enabled, mental health support program, was administered using a VR headset (Apple Vision Pro, Cupertino, CA). Patients following at the University of Chicago with CD or UC and a generalized anxiety disorder-7 (GAD-7) score of 5-14 were prospectively recruited. Participants engaged in a private 30-minute session with XAIA. Demographics were collected, and clinical disease activity was defined as Harvey Bradshaw Index >5 for CD or Simplified Clinical Colitis Activity Index >2 for UC. Participants completed Spielberg State Trait Anxiety Inventory and visual analog pain scales before and after the session. Following the VR experience, a semi-structured debrief interview was completed, and its transcription was reviewed for thematic content analysis. Results: Among the 14 participants, 7 (50%) had CD, 13 (93%) were women, 9 (64%) identified as White, 12 (86%) never smoked, 6 (43%) were receiving medication for a mental health disorder, and 5 (36%) had a clinical diagnosis of depression. Four patients (29%) had clinically active disease at the time of study participation. After completing 1 session with XAIA, participants noted improvement in total state-trait anxiety scores (96 vs 83, P = 0.01) and in visual analog pain scores (mean 2.7 vs 2.1, P = 0.03). Thematic analysis demonstrated 196 first-level codes, and saturation was achieved. Adverse events only included mild discomfort due to the weight of the headset. Conclusion: The use of a self-administered mental health support tool using AI-enabled CBT in an immersive VR environment is feasible and well tolerated in patients with CD or UC and mild-to-moderate anxiety. Participants noted significant improvement in state trait anxiety and visual analog pain scores after one session, supporting further study of this tool for short- and longer-term benefit in patients with CD or UC.