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

In the paper

“Nineteen studies were included in the review, and 10 RCTs (eight studies) were included in the meta-analysis.”

• Also stated in: § Results · plain

  “Thus, eight studies involving a total of 636 participants in 10 RCTs were eligible for inclusion in the final meta-analysis.”

In the paper

“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.”

In the paper

“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.”

• Also stated in: § Results · plain

  “They were divided into four categories based on the game types they involved: (a) psycho-education and training, (b) virtual reality exposure therapy, (c) exercising, and (d) entertainment.”

In the paper

“Nineteen studies were included in the review, and 10 RCTs (eight studies) were included in the meta-analysis.”

• Also stated in: § Results · plain

  “The search yielded a total of 1,179 articles, with 19 studies meeting the criteria for inclusion in the final review.”

In the paper

“Heterogeneity among the depression outcomes was moderate (I2=47%; Table 2).”

In the paper

“which was statistically significant (Z=−4.09, p<0.0001).”

In the paper

“inspection of the forest plot suggested that one comparison was a possible outlier.39”

In the paper

“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.”

In the paper

“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]).”

• Also stated in: § Results · plain

  “Across the 10 comparisons (eight studies) and a total of 387 game-based digital intervention groups and 388 control groups, there was a moderate effect size of d=−0.47 [95% CI −0.69 to −0.24]; Fig. 2) for self-reported depression posttest”

In the paper

“A higher effect was achieved when a waiting list was used as the control.”

In the paper

“The findings of the meta-analysis suggest that game-based digital applications in general have a moderate effect size (d=0.47) as depression therapy.”

• Also stated in: § Conclusion · plain

  “Four categories of game interventions were identified that had an overall medium effect size, as supported by a meta-analysis of available RCTs.”

In the paper

“Eleven out of the 19 studies recruited a small number of participants, with fewer than 50 people in each trial.”

In the paper

“Longman et al.13 used World of Warcraft to show that massively multiplayer online games led to fewer negative psychological symptoms.d”

What the sources say

• Not checked yetcites [13] source

In the paper

“However, in this study, the nontherapist supported interventions were reported to have a greater effect size than those with therapist support (d=0.54 vs. d=0.44), which is inconsistent with the results presented in these three previous reviews.”

In the paper

“Lastly, five studies were identified that assessed the feasibility and efficacy of entertainment gaming technology for mental health improvement.”

In the paper

“Li et al.39 also identified that virtual reality computer games had an effect on reducing children's depression symptoms in comparison with a control group in usual care.”

What the sources say

• Not checked yetcites [39] source

In the paper

“Significant reductions in depression were also found when interventions were used for specific driving phobia30 and acrophobia.38”

What the sources say

• Not checked yetcites [30] source
• Not checked yetcites [38] source

In the paper

“Three studies11,27,32 indicated that virtual reality exposure therapy was very effective for war posttraumatic stress disorder (PTSD).”

What the sources say

• Not checked yetcites [11] source
• Not checked yetcites [27] source
• Not checked yetcites [32] source

In the paper

“In many cases, due to incomplete reporting, several domains of the included studies were rated as unclear when their methodological quality was assessed.”

In the paper

“Casual games for relaxation, such as Bejeweled II,e,31 Freeze-Framer 2.0, and Journey to the Wild Divine,41 were also found to be useful in depression therapy.”

What the sources say

• Not checked yetcites [31] Russoniello CV, 2009, Studies in Health Technology & Informatics
• Not checked yetcites [41] Knox M, 2011, Mental Health in Family Medicine

In the paper

“Lastly, the findings also demonstrate that studies that used a waiting list control condition yielded a greater effect (d=−0.66 [95% CI −1.14 to −0.18]) than those using treatment as usual (d=−0.39 [95% CI −0.68 to −0.11]) or active treatments (d = −0.53 [95% CI −1.10 to 0.03]) as controls.”

In the paper

“The psycho-education and training interventions were developed mainly from traditional CBT, which is a widely used and effective form of depression therapy with a particular focus on problem-solving skills.43”

What the sources say

• Not checked yetcites [43] source

In the paper

“The majority of the studies were aimed at young people aged younger than 30 years.”

In the paper

“There is also a significant lack of data on the long-term effects of such interventions.”

In the paper

“In the study, it is interesting to note that there was a big variance between two trials from Fleming et al.'s12 and Sally et al.'s35 studies (d=−1.20 vs. d=−0.11; see Fig. 2), which in fact applied the same intervention (SPARX) under the same depression measurement (CDRS-R).”

What the sources say

• Not checked yetcites [12] source
• Not checked yetcites [35] Sally NM, 2012, British Medical Journal

In the paper

“The other two types of digital game therapies, exercising and entertainment, share the same purpose of relaxation.”

In the paper

“In our meta-analysis, only the RCT studies by Emmelkamp et al.38 and Proudfoot et al.37 reported some remaining benefits at the 6 month follow-up.”

What the sources say

• Not checked yetcites [38] source
• Not checked yetcites [37] source

In the paper

“Two studies were identified that presented interventions specifically for older adults older than 65 years.”

In the paper

“As digital game interventions for mental health is a relatively new research area, systematic reviews and meta-analyses of their effectiveness in treating depression are scarce.”

In the paper

“The review and meta-analysis support the effectiveness of game-based digital interventions for depression.”

In the paper

“A few recent reviews have focused on computer-based or Internet-delivered psychological interventions for depression disorders,14–17 but they did not specifically focus on digital intervention with a game component.”

What the sources say

• Not checked yetcites [14] source
• Not checked yetcites [15] source
• Not checked yetcites [16] source
• Not checked yetcites [17] source

In the paper

“Evidence from neuropsychological research further suggests the therapeutic value of game-based digital interventions in depression therapy, finding that positive game-playing experiences trigger the release of hormones such as endorphins and striatal dopamine7,8 that are responsible for feelings of pleasure and well-being.9,10”

What the sources say

• Not checked yetcites [7] source
• Not checked yetcites [8] source
• Not checked yetcites [9] source
• Not checked yetcites [10] source

In the paper

“Game-based digital interventions have been found to have practical effects in addressing the main barriers of access and engagement in the healthcare domain, particularly for the young.6”

What the sources say

• Not checked yetcites [6] source

In the paper

“Previous reviews that have targeted the use of video games to encourage health improvement18–20 have not covered the effects of such treatment on depression.”

What the sources say

• Not checked yetcites [18] source
• Not checked yetcites [19] source
• Not checked yetcites [20] source

In the paper

“Guided by reasoning, game-based interventions have specific potential for reducing depression through the natural benefits afforded by the game elements involved.”

In the paper

“This finding indicates that the majority of the included studies had a moderate effect on depression.”

In the paper

“The results reveal that game-based applications do not differ much from other forms of computerized interventions in terms of effectiveness in depression treatment.”

What the sources say

• Not checked yetcites [17] source
• Not checked yetcites [15] source
• Not checked yetcites [16] source

In the paper

“However, many people are unable or reluctant to access and engage in effective treatment due to barriers such as personal stigma, high costs, waiting lists, and a shortage of trained professionals.4”

What the sources say

• Not checked yetcites [4] source

In the paper

“In addition, the self-help features of this type of digital intervention reduce therapist time and effort during the education and training process.44”

What the sources say

• Not checked yetcites [44] source

In the paper

“The unique experience of virtual reality exposure therapy was reported to be particularly effective for reducing depression caused by fear.27,32”

What the sources say

• Not checked yetcites [27] source
• Not checked yetcites [32] source

In the paper

“Increasing evidence shows that a high percentage of such adults actively play digital video games in daily life.50,51”

What the sources say

• Not checked yetcites [50] Lenhart A, 2008, Pew Internet and American Life Project
• Not checked yetcites [51] McGonigal J, 2011