Can an action video game help people with depression?
Depressed patients who played a fast action video game for six weeks reported less rumination and better thinking than a wait-list group, but their depression scores did not change and the effects were fragile.
Source
Fighting Depression: Action Video Game Play May Reduce Rumination and Increase Subjective and Objective Cognition in Depressed Patients
Study at a glance
- Design
- RCT — Randomised wait-list-controlled online trial: 6 weeks of home play of the action game Boson X versus no intervention; ANCOVAs on posttest scores controlling for pretest score, habitual gaming and sex
- N
- N=50 · 68 randomised; main analysis included 21 video game and 29 control participants after listwise deletion; cognitive tests were completed by only 9 game and 10 control participants
- Population
- Adults aged 18-65 with a verified diagnosis of major depression or dysthymia, recruited by email from former participants of a psychiatry department in Hamburg, Germany
- Outcome
- Depression severity (BDI, PHQ-9), trait rumination (RSQ), subjective cognition (SSTICS), and online cognitive tests including the Trail Making Test
Structured fields used in claim comparison tables when every cited study has a complete layer.
What they did
Adults with diagnosed depression were randomly assigned either to play the fast-paced action game Boson X at home for six weeks or to a wait-list control that got the game only afterwards. Before and after, everyone completed online questionnaires on depression, rumination (repetitive dwelling on negative feelings) and self-rated cognitive problems, and some also did online cognitive tests. Groups were compared at posttest while statistically adjusting for their starting scores, habitual gaming and sex.
What they found
The gaming group had lower rumination and higher self-rated cognition at posttest than controls, with the self-rated gain mostly in episodic memory. There was no group difference on either depression measure. In the small subsample with cognitive tests, gamers were faster on the Trail Making Test, but not on working memory, processing speed or spatial tasks. None of these effects survived correction for multiple comparisons, and self-rated cognition did not correlate with actual test performance.
The limits
What it doesn't show
With 21 gamers and 29 controls analysed, and only 9 gamers and 10 controls completing the cognitive tests, the study had low power and its significant results disappear after Bonferroni correction, so they should be treated as preliminary. The control group did nothing, so improvements could reflect expectations, distraction or simply having an activity, and participants knew which group they were in. Training happened unsupervised at home, play time was self-reported for most people, and groups differed at baseline in sex and PHQ-9 scores. It does not show that video games treat depression itself, since mood scores did not improve.
Key terms
- Rumination
- Repetitive, passive focus on one's negative feelings and their causes, which can trigger and prolong depressive episodes.
- Wait-list control
- A comparison group that receives no intervention during the study and gets it afterwards; it controls for time but not for expectations or activity.
- ANCOVA
- Analysis of covariance: comparing groups on an outcome while statistically adjusting for other variables such as baseline scores.
- Bonferroni correction
- Lowering the significance threshold when running several tests, to reduce the chance of false positives.
- Trail Making Test
- A task connecting numbered (and alternating number-letter) circles as fast as possible, measuring processing speed and cognitive flexibility.
- Subjective vs objective cognition
- How well people believe their thinking works versus how they actually perform on cognitive tests.
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Quiz yourself
What was the main outcome that improved in the video game group?
Common questions
If depression scores didn't drop, why does reduced rumination matter?
Rumination is a key driver that can start and prolong depressive episodes, so reducing it could be a useful target even if mood has not yet changed.
Why might an action game affect rumination?
The authors speculate that action games train executive functions such as inhibiting thoughts, which could help people stop ruminating, but they did not measure inhibition directly.
What would a stronger follow-up study look like?
A larger trial with an active control activity (for example reading on a tablet), logged play time, blinded expectations and correction for multiple outcomes.
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