Gaming‑Based Community Intervention for Loneliness in Adult Gamers: Longitudinal Observational Study

Loneliness is a form of psychological distress associated with increased risk of depression, anxiety, and adverse health outcomes across the life span. This study evaluates an online gaming‑based community intervention that combines professionally facilitated groups, commercial video games, and skills‑focused workshops for adults who play video games.

This study aimed to examine the feasibility of this health‑supporting gaming community and to characterize 30‑ and 60‑day changes in depression, anxiety, psychological well‑being, and psychological flexibility, as well as heterogeneous trajectories of depressive symptoms.

In a longitudinal observational study, adults in the United States self‑enrolled in a gaming therapeutics community hosted on Discord. Participants completed baseline, 30‑day, and 60‑day assessments including the Patient Health Questionnaire‑9 (PHQ‑9), Generalized Anxiety Disorder‑7 Scale, World Health Organization-5 Well‑Being Index, and Psychological Flexibility Scale (Psy‑Flex). Of 438 participants with 30‑day data, 403 met inclusion criteria for longitudinal analyses and 157 (35.6%) completed the 60‑day survey. Within‑person change scores and standardized mean differences were calculated, and latent growth mixture modeling was used to identify depressive‑symptom trajectories and baseline predictors of nonresponse versus improvement.

At baseline, mean PHQ‑9 score was 13.37 (SD 6.04), decreasing to 10.27 (SD 5.80) at 60 days (Cohen d=0.52). Mean Generalized Anxiety Disorder‑7 scores decreased from 11.23 (SD 5.24) to 8.25 (SD 4.22) (Cohen d=0.60). Psy‑Flex scores increased from 11.51 (SD 4.30) to 12.55 (SD 4.37; Cohen d=0.24), and World Health Organization‑5 Well‑Being Index scores increased from 7.86 (SD 3.82) to 8.08 (SD 4.44; Cohen d=0.24). Latent growth mixture modeling identified 3 depressive‑symptom trajectories: a low group (229/438, 52.3%; baseline PHQ‑9 mean 8.80 (SD 3.67); 60‑day mean 7.64, SD 3.87), a chronic group (118/438, 26.9%; baseline mean 18.30 (SD 4.03); 60‑day mean 16.78, SD 4.10), and an improvers group (91/438, 20.8%; baseline mean 18.52, SD 3.13; 60‑day mean 7.42, SD 4.27). In logistic regression among participants with moderate‑to‑severe baseline depression, a gender identity other than woman was associated with lower odds of belonging to the Improvers versus Chronic group (odds ratio 0.42, 95% CI 0.19-0.94). Post hoc analyses indicated lower odds of improvement for nonbinary participants compared with women (odds ratio 0.25, 95% CI 0.10-0.59). No other baseline characteristics significantly distinguished chronic versus improving trajectories.

A professionally moderated, gaming‑based community intervention was feasible to deliver, engaged a diverse sample of adult gamers, and was associated with medium‑sized reductions in depressive and anxiety symptoms and small improvements in well‑being and psychological flexibility over 60 days. A subgroup moved from moderate‑to‑severe symptoms to subthreshold depressive symptoms. These findings support further controlled evaluation of health‑supporting gaming communities as a scalable support and potential preventive context for adult gamers experiencing distress.