JMIR Publications

ABSTRACT

Background:

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

Objective:

Based on these findings, we developed a gamified SBI (mentalis Phoenix; MT-Phoenix) and hypothesized the program to 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 N=77 individuals with elevated depression scores (PHQ-9 scores ≥5). Participants were instructed to either train for 14-days with MT-Phoenix or were assigned to a waitlist control condition. Engagement with the intervention was measured by assessing usage data. Primary outcome was reduction in depressive symptom severity at post-assessment.

Results:

Data from this pilot trial shows that participants in the intervention group used the SBI at 45.6% of all days and reported a significantly greater reduction of depressive symptoms than did participants in the control condition (d=1.02). Effects were sustained at a 3-months follow-up.

Conclusions:

A gamified SBI 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 III trial using clinical samples. Moreover, the intervention should be compared to active control conditions. Clinical Trial: The trial was registered at the German Clinical Trial Registry (DRKS00012769).