A gamified smartphone-based intervention for depression: Randomized Controlled Pilot Trial.

Lukas C, Eskofier B, Berking M (2021)

Publication Type: Journal article, Original article

Publication year: 2021


Book Volume: 8

Article Number: e16643

Journal Issue: 7

DOI: 10.2196/16643


Background: Available smartphone-based interventions for depression predominantly use evidence-based strategies from cognitive-behavioral therapy (CBT), but patient engagement and reported effect sizes are small. Recently, studies have demonstrated that smartphone-based interventions combining CBT with gamified approach-avoidance bias modification training (AAMT) can foster patient engagement and reduce symptoms of several mental health problems.

Objective: Based on these findings, we developed a gamified smartphone-based intervention, mentalis Phoenix (MT-Phoenix), and hypothesized the program would both engage patients and produce preliminary evidence for the reduction of depressive symptoms.

Methods: To test this hypothesis, we evaluated MT-Phoenix in a randomized controlled pilot trial including 77 individuals with elevated depression scores (Patient Health Questionnaire-9 scores ≥5). Participants were either instructed to train for 14 days with MT-Phoenix or assigned to a waitlist control condition. Engagement with the intervention was measured by assessing usage data. The primary outcome was reduction in depressive symptom severity at postassessment.

Results: Data from this pilot trial shows that participants in the intervention group used the smartphone-based intervention for 46% of all days (6.4/14) and reported a significantly greater reduction of depressive symptoms than did participants in the control condition (F1,74=19.34; P=.001), with a large effect size (d=1.02). Effects were sustained at a 3-month follow-up.

Conclusions: A gamified smartphone-based intervention combining CBT with AAMT may foster patient engagement and effectively target depressive symptoms. Future studies should evaluate the effectiveness of this intervention in a phase 3 trial using clinical samples. Moreover, the intervention should be compared to active control conditions.

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Lukas, C., Eskofier, B., & Berking, M. (2021). A gamified smartphone-based intervention for depression: Randomized Controlled Pilot Trial. JMIR Mental Health, 8(7). https://dx.doi.org/10.2196/16643


Lukas, Christian, Björn Eskofier, and Matthias Berking. "A gamified smartphone-based intervention for depression: Randomized Controlled Pilot Trial." JMIR Mental Health 8.7 (2021).

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