AUTHOR=Weller Simone , Schroeder Philipp A. , Plewnia Christian 

TITLE=Gamification improves antidepressant effects of cognitive control training—A pilot trial

JOURNAL=Frontiers in Digital Health

VOLUME=Volume 4 - 2022

YEAR=2022

URL=https://www.frontiersin.org/journals/digital-health/articles/10.3389/fdgth.2022.994484

DOI=10.3389/fdgth.2022.994484

ISSN=2673-253X

ABSTRACT=Computerised cognitive trainings have been put forward to improve control over negatively biased information processing and associated depressive symptomatology. Yet, disease-related impairments of motivation and endurance, as well as insufficient accessibility hinder use of this promising therapeutic opportunity. Here, we developed an app (de:)press) that utilizes a cognitive control training (paced auditory serial addition task) enriched with gami-fication and information elements. We compared a six-week training with de:)press to a non-gamified version (active control group).

Thirty-two depressed participants were included. Each received either de:)press or the non-gamified version and was instructed to train three times per week for two weeks. After-wards (four weeks) they were free to train at their own discretion. Depression severity was assessed during training and two follow-up sessions. Primary endpoint was defined as differ-ence between groups (change of Montgomery-Åsberg Depression Rating Scale [MADRS]) four weeks after end of training.

Depression severity decreased in both groups. At primary endpoint, MADRS scores were significantly lower in the de:)press-group compared to the control group. No differences were observed at three months’ follow-up. Intervention usability was consistently rated posi-tively. Participants who had trained with de:)press maintained the recommended training frequency without further prompting. Besides transient fatigue or frustration, no adverse effects were observed.

This pilot demonstrates that gamification and information elements can substantially in-crease cognitive control training efficacy in alleviating depressive symptoms. Moreover, it provides first evidence for the feasibility and efficacy of de:)press as an add-on intervention to treat depression.