A smartphone-based serious game to improve mental health and medication adherence in adults with depression: A randomised controlled trial.
Josefin Brehmer, Matilda Berg, Gabriel Astudillo et al.
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In 30 seconds
This randomised controlled trial tested a 9-week digital intervention in 148 adults receiving antidepressants who had residual depressive symptoms. The intervention combined a CBT-based smartphone game, optional internet-based CBT modules and therapist guidance on demand; the comparator was a waitlist. At post-treatment, regression models favoured the intervention for depressive symptoms (d = 0.74), anxiety symptoms (d = 0.67) and medication adherence (d = 0.46). At least 30% improvement in depressive symptoms occurred in 51.11% vs. 18.64%. Quality of life did not differ significantly.
Key findings
- Post-treatment models favoured the intervention for depressive symptoms (d = 0.74), anxiety symptoms (d = 0.67) and medication adherence (d = 0.46).
- At least 30% improvement was reached by 51.11% vs. 18.64% of intervention and control participants, respectively.
- Quality of life did not differ significantly between groups.
- Attrition was 40.8% in the intervention group and 18.1% in the control group.
Why it matters
Residual symptoms and low adherence can persist during antidepressant treatment. This trial suggests that a multicomponent digital programme may offer short-term benefits across depressive symptoms, anxiety and adherence compared with waiting, while showing no significant quality-of-life difference. The findings are relevant to evaluating digital support as an adjunct, but do not establish which component produced the observed effects.
What to keep in mind
Differential attrition, open-label design, a waitlist comparator and self-reported outcomes limit conclusions; effects cannot be attributed to the game alone.