Primary care clinicians who used artificial intelligence (AI) scribes for note taking were less likely to provide a depression diagnosis or intervention for their patients, according to a study issued today by
JAMA Psychiatry. Yet, the AI scribes documented more neuropsychiatric symptoms than human notes on average.
Why It’s Relevant
The use of ambient AI scribes, which utilize speech recognition and large language models to generate clinical notes automatically, has rapidly become widespread in medicine. However, little is known about how this might impact the documentation and management of neuropsychiatric symptoms.
By the Numbers
- The researchers examined the clinical notes for 20,302 adults’ annual checkups, including 5,076 that were generated by an AI scribe. All the checkups included patient completion of the Patient Health Questionnaire-9 (PHQ-9).
- Across the board, 5% of patients had moderate to severe depression (PHQ-9 score ≥ 10).
- Compared with notes created by a human scribe or no scribe (written during the checkup), notes created by an ambient AI scribe were more likely to record psychiatric symptoms across multiple domains (such as positive and negative feelings, cognition, and social functioning).
- The presence of any depression diagnosis, antidepressant prescription, or behavioral health care referral was lower among visits that used an ambient AI scribe: 14% versus 17% among visits with a human scribe or no scribe.
The Other Side
Differences in patient populations not captured by sociodemographic features could account for differential documentation. Larger-scale prospective studies may be needed to determine causal effects.
Takeaway Message
“Increased documentation did not translate to increased attention to depressive symptoms,” the researchers wrote. “One explanation for this association could be that automating documentation leads clinicians to be less active in general, analogous to reduced proficiency observed in pilots after the emergence of autopilot.”
Related Information
Source
Victor M. Castro et al. Psychiatric documentation and management in primary care with artificial intelligence scribe use. JAMA Psychiatry. Published January 21, 2026. doi: 10.1001/jamapsychiatry.2025.4303.
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