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Depression

Can an action video game help people with depression?

Kühn S, Berna F, Lüdtke T, et al. · Frontiers in psychology · 2018

Open access · cc by · source: Europe PMC

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.

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

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Key findings

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.

Methodology

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.

Limitations

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.

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