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Individualized rTMS Treatment for Depression using an fMRI-Based Targeting Method

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A Gamified Smartphone-Based Intervention for Depression: Randomized Controlled Pilot Trial.

Christian Aljoscha Lukas¹, Bjoern Eskofier², Matthias Berking¹

¹Department of Clinical Psychology and Psychotherapy, Friedrich-Alexander-University Erlangen-Nuremberg, Erlangen, Germany.

JMIR Mental Health

|July 20, 2021

Summary

A new gamified smartphone app combining cognitive-behavioral therapy with approach-avoidance bias modification training significantly reduced depressive symptoms and improved patient engagement. These positive effects were sustained at 3-month follow-up.

Keywords:

approach/avoidance cognitive behavioral therapy depression gamification smartphone technology

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Area of Science:

Digital mental health
Psychiatry
Psychology

Background:

Smartphone-based interventions for depression often show low engagement and small effect sizes.
Combining cognitive-behavioral therapy (CBT) with gamified approach-avoidance bias modification training (AAMT) shows promise for improving engagement and reducing symptoms.
The mentalis Phoenix (MT-Phoenix) app was developed integrating CBT and gamified AAMT.

Purpose of the Study:

To develop and evaluate the gamified smartphone intervention, MT-Phoenix.
To hypothesize that MT-Phoenix would enhance patient engagement and reduce depressive symptoms.

Main Methods:

A randomized controlled pilot trial involved 77 individuals with elevated depression scores (PHQ-9 ≥5).
Participants were assigned to either 14 days of MT-Phoenix training or a waitlist control group.
Engagement was measured by usage data; the primary outcome was the reduction in depressive symptom severity.

Main Results:

Participants using MT-Phoenix engaged with the app on 46% of days (6.4/14).
The intervention group showed a significantly greater reduction in depressive symptoms compared to the control group (P=.001) with a large effect size (d=1.02).
Observed benefits were sustained at a 3-month follow-up.

Conclusions:

A gamified smartphone intervention merging CBT with AAMT can enhance patient engagement and effectively target depressive symptoms.
Further research is warranted, including phase 3 trials with clinical samples and comparisons to active control groups.