Gamified digital mental health interventions show modest effects in treating youth with ADHD and depression

A recent meta-analysis of experimental studies examining the effectiveness of gamified digital mental health interventions found that these treatments showed modest effects in reducing symptoms of ADHD and depression. However, they were not effective in addressing anxiety disorders. The study revealed that ADHD treatments delivered on a computer and those tested on groups with a higher percentage of boys produced stronger effects. These findings were published in JAMA Pediatrics.

Anxiety, depression, and attention-deficit/hyperactivity disorder (ADHD) are the most common mental health disorders affecting children. It is estimated that up to 20% of children experience these conditions, and many display symptoms of more than one disorder. Common symptoms include low mood, excessive worry, difficulty focusing, hyperactivity, and impulsive behavior. Each of these symptoms can significantly impair a child’s ability to function in school, at home, and in social settings.

If left untreated, these disorders can persist into adulthood, increasing the risk of developing more severe mental health issues. While treatments such as psychotherapy and medications are available, they can be burdensome. Medication often requires continuous administration, and psychotherapy involves regular sessions with trained professionals, which can be costly and time-consuming for families. Moreover, accessing these treatments is often difficult due to the limited availability of mental health professionals, particularly for children.

“We found literature that suggests that even doubling the number of pediatric mental health providers still wouldn’t meet the need,” said Barry Bryant, a resident in the Department of Psychiatry and Behavioral Sciences in the Johns Hopkins University School of Medicine and first author of the new study.

Digital mental health interventions have emerged as a promising solution to these challenges. These interventions use technology platforms—such as computers, tablets, video game consoles, and smartphones—to deliver therapeutic activities aimed at improving mental health. Although research has shown some effectiveness for these treatments, engagement remains a significant challenge. Children and adolescents may download these apps or games but often struggle to consistently engage with the therapeutic content, especially if they lack motivation or have issues with attention.

To better understand the potential of digital mental health interventions, Bryant and his colleagues conducted a meta-analysis of studies exploring the effects of these interventions on symptoms of depression, anxiety, and ADHD in children. The researchers conducted a meta-analysis to consolidate the findings of various studies to provide a clearer picture of how effective these interventions are in treating the most common mental health disorders in childhood.

The researchers conducted a systematic search of scientific databases, using terms like “ADHD,” “depression,” “anxiety,” “youth,” “children,” and “adolescents,” while focusing on interventions described as “videogame,” “computer game,” or “game-based.” This search identified 27 studies that met the criteria for inclusion. Of these, 11 studies focused on ADHD, 9 on depression, and 12 on anxiety. Collectively, these studies involved 2,911 participants, with ages ranging from 8 to 17 years old.

The analysis revealed that gamified digital mental health interventions showed modest positive effects in treating both ADHD and depression, but they did not demonstrate significant benefits for anxiety disorders. Importantly, the effectiveness of these interventions varied based on several factors.

ADHD treatments were more effective when delivered via computer rather than other devices, such as tablets. One possible explanation is that computers are often used in more controlled, less distracting environments (e.g., at a desk), while tablets may be used in a variety of settings with more distractions.

Sex differences also emerged, with treatments for ADHD being more effective in groups that included a larger proportion of boys. This could be due to the types of gamified interventions used, which may have been more appealing to boys, such as action or driving games.

For depression, treatments that imposed preset time limits were associated with better outcomes. Structured time limits may help keep children engaged with the therapeutic content, allowing them to focus and derive more benefit from the intervention.

“While the benefits are still modest, our research shows that we have some novel tools to help improve children’s mental health — particularly for ADHD and depression — that can be relatively accessible to families,” said Joseph McGuire, an author of the study and an associate professor of psychiatry and behavioral sciences in the school of medicine. “So if you are a pediatrician and you’re having trouble getting your pediatric patient into individual mental health care, there could be some gamified mental health interventions that could be nice first steps for children while waiting to start individual therapy.”

The study sheds light on the effects of gamified digital mental health interventions on symptoms of common mental health disorders in childhood. However, it should be noted that the examined treatments were very diverse. It can be expected that the effectiveness of an intervention largely depends on the characteristics of the intervention, not so much on the fact that it is delivered through a technology platform. If the examined set of interventions was different, results would likely be different as well.

The paper, “Efficacy of Gamified Digital Mental Health Interventions for Pediatric Mental Health Conditions A Systematic Review and Meta-Analysis,” was authored by Barry R. Bryant, Morgan R. Sisk, and Joseph F. McGuire.