Serious games for the treatment or prevention of depression: A systematic review

Serious games (computerised interventions which utilise gaming for serious purposes) have been shown to support improved outcomes in several health conditions. We aimed to review evidence regarding serious games for depression. We undertook electronic searches of PsycInfo, EMBASE and Medline, using terms relevant to computer games and depression. We included fulltext articles published in English in peer-reviewed literature since 2000, where the intervention was designed to treat or prevent depression and which included pre-and post-intervention measurement of depression. Nine studies relating to a total of six interventions met inclusion criteria. Most studies were small and were carried out by the developers of the programs. All were tested with young people (ages between 9 and 25 years). Most reported promising results with some positive impact on depression although one universal program had mixed results. Serious gaming interventions show promise for depression, however evidence is currently very limited.

[1]  T. B. Üstün,et al.  Global burden of depressive disorders in the year 2000 , 2004, British Journal of Psychiatry.

[2]  Luz María Alvarez,et al.  Computer program in the treatment for major depression and cognitive impairment in university students , 2008, Comput. Hum. Behav..

[3]  Leanne M. Casey,et al.  Dropout from Internet-based treatment for psychological disorders. , 2010, The British journal of clinical psychology.

[4]  Michael Kyrios,et al.  An evaluation of 'Reach Out Central': an online gaming program for supporting the mental health of young people. , 2010, Health education research.

[5]  T. Richardson,et al.  Computerized CBT (Think, Feel, Do) for Depression and Anxiety in Children and Adolescents: Outcomes and Feedback from a Pilot Randomized Controlled Trial , 2011, Behavioural and Cognitive Psychotherapy.

[6]  Dion Hoe-Lian Goh,et al.  Strategies for designing effective psychotherapeutic gaming interventions for children and adolescents , 2008, Comput. Hum. Behav..

[7]  N. Lindefors,et al.  Cognitive behavior therapy via the Internet: a systematic review of applications, clinical efficacy and cost–effectiveness , 2012, Expert review of pharmacoeconomics & outcomes research.

[8]  J. Ioannidis,et al.  The PRISMA Statement for Reporting Systematic Reviews and Meta-Analyses of Studies That Evaluate Health Care Interventions: Explanation and Elaboration , 2009, Annals of Internal Medicine [serial online].

[9]  Amy Przeworski,et al.  A review of technology-assisted self-help and minimal contact therapies for drug and alcohol abuse and smoking addiction: is human contact necessary for therapeutic efficacy? , 2011, Clinical psychology review.

[10]  M. Prensky Digital Natives, Digital Immigrants Part 1 , 2001 .

[11]  Bruce Neal,et al.  Rethinking the Dose-Response Relationship Between Usage and Outcome in an Online Intervention for Depression: Randomized Controlled Trial , 2013, Journal of medical Internet research.

[12]  Russell E. Glasgow,et al.  Implementation science approaches for integrating eHealth research into practice and policy , 2014, Int. J. Medical Informatics.

[13]  Derek Richards,et al.  Computer-based psychological treatments for depression: a systematic review and meta-analysis. , 2012, Clinical psychology review.

[14]  Alessandro De Gloria,et al.  Mapping learning and game mechanics for serious games analysis , 2015, Br. J. Educ. Technol..

[15]  J. Proudfoot,et al.  The development and beta-test of a computer-therapy program for anxiety and depression: hurdles and lessons , 2003, Comput. Hum. Behav..

[16]  H. Wittchen,et al.  Size and burden of mental disorders in Europe—a critical review and appraisal of 27 studies , 2005, European Neuropsychopharmacology.

[17]  T. Furukawa,et al.  Is computerised CBT really helpful for adult depression?-A meta-analytic re-evaluation of CCBT for adult depression in terms of clinical implementation and methodological validity , 2013, BMC Psychiatry.

[18]  M. Green,et al.  Digital natives , 2012, BDJ.

[19]  T. Fleming,et al.  ‘It’s mean!’ The views of young people alienated from mainstream education on depression, help seeking and computerised therapy , 2012 .

[20]  Mathijs F. G. Lucassen,et al.  The views of lesbian, gay and bisexual youth regarding computerised self-help for depression: An exploratory study , 2013 .

[21]  E. Mayo-Wilson Internet-based cognitive behaviour therapy for symptoms of depression and anxiety: a meta-analysis. , 2007, Psychological medicine.

[22]  Kathleen M Griffiths,et al.  The use of e‐health applications for anxiety and depression in young people: challenges and solutions , 2011, Early intervention in psychiatry.

[23]  H. Christensen,et al.  Delivering interventions for depression by using the internet: randomised controlled trial , 2004, BMJ : British Medical Journal.

[24]  Deborah I Thompson,et al.  Playing for real: video games and stories for health-related behavior change. , 2008, American journal of preventive medicine.

[25]  Anya Andrews Serious Games for Psychological Health Education , 2011, HCI.

[26]  J. Weisz,et al.  Effects of psychotherapy for depression in children and adolescents: a meta-analysis. , 2006, Psychological bulletin.

[27]  T. Richardson,et al.  Universal and targeted computerised cognitive behavioural therapy (Think, Feel, Do) for emotional health in schools: results from two exploratory studies. , 2012, Child and adolescent mental health.

[28]  Theresa Fleming,et al.  A pragmatic randomized controlled trial of computerized CBT (SPARX) for symptoms of depression among adolescents excluded from mainstream education. , 2012, Behavioural and cognitive psychotherapy.

[29]  Hannes Kaufmann,et al.  Playmancer: Games for Health with Accessibility in Mind , 2009 .

[30]  David Coyle,et al.  Exploratory evaluations of a computer game supporting cognitive behavioural therapy for adolescents , 2011, CHI.

[31]  Marina Papastergiou,et al.  Exploring the potential of computer and video games for health and physical education: A literature review , 2009, Comput. Educ..

[32]  Mary Jo Dondlinger,et al.  Educational Video Game Design: A Review of the Literature , 2007 .

[33]  Randall Shumaker Virtual and Mixed Reality - Systems and Applications - International Conference, Virtual and Mixed Reality 2011, Held as Part of HCI International 2011, Orlando, FL, USA, July 9-14, 2011, Proceedings, Part II , 2011, HCI.

[34]  R. Bowen Loftin,et al.  VR's frames of reference: a visualization technique for mastering abstract multidimensional information , 1999, CHI '99.

[35]  M Knox,et al.  Game-based biofeedback for paediatric anxiety and depression. , 2011, Mental health in family medicine.

[36]  Tim Marsh,et al.  Serious games continuum: Between games for purpose and experiential environments for purpose , 2011, Entertain. Comput..

[37]  Elizabeth Murray,et al.  Interactive Health Communication Applications for people with chronic disease. , 2005, The Cochrane database of systematic reviews.

[38]  Chris Dede,et al.  Immersive Interfaces for Engagement and Learning , 2009, Science.

[39]  Stephen M Shortell,et al.  Interactive games to promote behavior change in prevention and treatment. , 2011, JAMA.

[40]  James M. Boyle,et al.  A systematic literature review of empirical evidence on computer games and serious games , 2012, Comput. Educ..

[41]  Gavin Andrews,et al.  Acceptability of Internet Treatment of Anxiety and Depression , 2011, Australasian psychiatry : bulletin of Royal Australian and New Zealand College of Psychiatrists.

[42]  Jessica Holt,et al.  A systematic review of internet-based self-management interventions for youth with health conditions. , 2009, Journal of pediatric psychology.

[43]  T. Richardson,et al.  Computerised Cognitive Behavioural Therapy for the Prevention and Treatment of Depression and Anxiety in Children and Adolescents: A Systematic Review , 2010, Clinical child and family psychology review.

[44]  H. Christensen,et al.  Review of internet‐based prevention and treatment programs for anxiety and depression in children and adolescents , 2010, The Medical journal of Australia.

[45]  Mathijs F. G. Lucassen,et al.  The effectiveness of SPARX, a computerised self help intervention for adolescents seeking help for depression: randomised controlled non-inferiority trial , 2012, BMJ : British Medical Journal.