Game-Based Digital Interventions for Depression Therapy: A Systematic Review and Meta-Analysis

Abstract

The aim of this study was to review the existing literature on game-based digital interventions for depression systematically and examine their effectiveness through a meta-analysis of randomized controlled trials (RCTs). Database searching was conducted using specific search terms and inclusion criteria. A standard meta-analysis was also conducted of available RCT studies with a random effects model. The standard mean difference (Cohen's d) was used to calculate the effect size of each study. Nineteen studies were included in the review, and 10 RCTs (eight studies) were included in the meta-analysis. Four types of game interventions-psycho-education and training, virtual reality exposure therapy, exercising, and entertainment-were identified, with various types of support delivered and populations targeted. The meta-analysis revealed a moderate effect size of the game interventions for depression therapy at posttreatment (d=-0.47 [95% CI -0.69 to -0.24]). A subgroup analysis showed that interventions based on psycho-education and training had a smaller effect than those based on the other forms, and that self-help interventions yielded better outcomes than supported interventions. A higher effect was achieved when a waiting list was used as the control. The review and meta-analysis support the effectiveness of game-based digital interventions for depression. More large-scale, high-quality RCT studies with sufficient long-term data for treatment evaluation are needed.

Serious Games and Gamification for Mental Health: Current Status and Promising Directions

“…Two reviews (9, 32) examined serious games for depression, while Li et al (31) focused specifically on a subset of serious games, exergames. Fleming et al (9) identified nine studies of six computerized interventions that utilized gaming as a major or primary component to treat or prevent depression.…”

Effectiveness of Serious Gaming During Multidisciplinary Rehabilitation for Patients with Complex Chronic Pain or Fatigue: A Natural Quasi-experiment (Preprint)

“…This evaluation addresses a unique combination of setting, patient and intervention characteristics (mindfulness approach and blended mode of supply). Achieving the predetermined required sample size for observing a modest effect with reasonable chance responds to previous reviews on the effectiveness of games for health that found promising results of mainly small, underpowered, studies [35,40]. Furthermore, this study has taken account of Type I error risk through outcome multiplicity, factors of non-usage, and risk of biased patient expectations through the informed consent procedure.…”

“…It was previously hypothesized that behavioral change is strengthened by engagement qualities triggered by storytelling, fantasy, and interactivity in serious games [34]. In the fields of mental health care and rehabilitation, gaming, motion capturing, and virtual reality technologies may support treatment effectiveness for various wellknown conditions such as depression, anxiety, phobias, post-stroke, and acute pain [39][40][41][42]. Adequately powered studies on the effects of games for health are lacking in general, and little to nothing is known about complementary effectiveness in regular health care contexts, such as multidisciplinary rehabilitation [43].…”

Games for the Assessment and Treatment of Mental Health

“…The community for research on video games for assessment and intervention for mental health spans multiple disciplines, from cognitive sciences, computer science, and interaction design, to psychology, neurobiology, and medicine [24]. The goal of this workshop is to bring together an international group of researchers to discuss the current state of games for mental and formulate a plan for moving this research agenda forward in the CHI PLAY community.…”