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Meta-Analysis
. 2024 Nov 1;178(11):1136-1146.
doi: 10.1001/jamapediatrics.2024.3139.

Efficacy of Gamified Digital Mental Health Interventions for Pediatric Mental Health Conditions: A Systematic Review and Meta-Analysis

Barry R Bryant  1 , Morgan R Sisk  2 , Joseph F McGuire  1
Affiliations
Meta-Analysis

Efficacy of Gamified Digital Mental Health Interventions for Pediatric Mental Health Conditions: A Systematic Review and Meta-Analysis

Barry R Bryant et al. JAMA Pediatr. .

Abstract

Importance: Anxiety, depression, and attention-deficit/hyperactivity disorder (ADHD) affect up to 20% of children and adolescents. Despite demonstrated efficacy, evidence-based treatments for these conditions are often inaccessible; innovative solutions are essential to meet the demand for pediatric mental health care.

Objective: To examine the efficacy and moderators of gamified DMHIs for anxiety, depression, and ADHD in randomized clinical trials (RCTs) for children and adolescents.

Data sources: A systematic search of PubMed, PsycInfo, and Web of Science was conducted for RCTs published before March 20, 2024.

Study selection: RCTs that evaluated the efficacy of gamified DMHIs for treating pediatric ADHD, depression, or anxiety were included. Studies were excluded if they did not use a gamified DMHI, provide sufficient data for effect sizes, or were unavailable in English.

Data extraction and synthesis: Efficacy data were extracted from rating scales for ADHD, depression, and anxiety. Extracted moderator variables included participant characteristics (eg, age and sex), intervention characteristics (eg, delivery modality and time limit), and trial design characteristics (eg, outcome measure and risk of bias).

Main outcomes and measures: The primary outcome was change in ADHD, depression, or anxiety severity in the treatment group compared to the control group. Hedges g quantified treatment effects.

Results: The search strategy identified 27 RCTs that included 2911 participants across ADHD, depression, and anxiety disorders. There were modest significant effects of gamified DMHIs on ADHD (g, 0.28; 95% CI, 0.09 to 0.48) and depression (g, 0.28; 95% CI, 0.08 to 0.47) but small, nonsignificant effects for anxiety disorders (g, 0.07; 95% CI, -0.02 to 0.17). Moderator analyses revealed that DMHIs for ADHD delivered on a computer and those RCTs that had a greater preponderance of male participants produced larger treatment effects. DMHIs for depressive disorders that used preset time limits for gamified DMHIs also exhibited larger treatment effects.

Conclusions and relevance: The findings suggest a benefit of gamified DMHIs for youth with ADHD or depressive disorder. Pediatricians and other health care professionals have new information about novel, accessible, and efficacious options for pediatric mental health care.

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Conflict of interest statement

Conflict of Interest Disclosures: Dr McGuire reported grants from the National Institutes of Health, Tourette Association of America, and Misophonia Research Fund and personal fees from Emalex Biosciences, Syneos Health, Noema Pharma, Elsevier, and Springer Nature outside the submitted work. No other disclosures were reported.

Figures

Figure 1.
Figure 1.. PRISMA Flow Diagram of Selection of Randomized Controlled Trials (RCTs)
ADHD indicates attention-deficit/hyperactivity disorder. aOne article included 2 gamified digital mental health intervention (DMHI) conditions, yielding an analysis of 27 RCTs in total.
Figure 2.
Figure 2.. Overall Summary Effects and by Condition
ADHD indicates attention-deficit/hyperactivity disorder.
See this image and copyright information in PMC

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