A Systematic Review of Artificial Intelligence in Positive and Existential Psychiatry for Mental and Emotional Health: The Role of Metacompetency Development

Positive and existential psychiatry are approaches to mental health that emphasize the promotion of well-being, resilience, and optimal functioning alongside the management of mental illness. Research suggests that the development of self-regulatory me-ta-competencies is associated with positive mental health and well-being outcomes. Ar-tificial intelligence (AI) technologies are increasingly being used as assistive tools in psychiatry. However, the integration of AI in therapeutic interventions remains under-explored. Thus, this systematic review aimed to examine whether AI-based positive and existential psychiatry interventions contribute to improvements in mental and emotional health, with a special focus on the metacompetency development. The review was con-ducted according to PRISMA 2020 guidelines. Only experimental studies including ran-domized controlled trials (RCTs) published from 2015 to 2025 were included. Twen-ty-four studies met the inclusion criteria. Across interventions using chatbots, generative AI tools, embodied agents, and AI-guided reflective systems, consistent improvements were observed in depression, anxiety, stress, well-being, positive affect, and loneliness. Many interventions enhanced metacompetencies such as emotional regulation, emotional awareness, self-reflection, and cognitive reappraisal. The findings suggest that AI-based positive and existential psychiatry interventions can support mental and emotional health, especially when fostering key metacompetencies. Although promising, further high-quality trials are needed to clarify long-term effects. The findings of this study can contribute to the discussion about the ways AI-supported interventions may promote sustainable mental health.