%0 Journal Article
%@ 2368-7959
%I JMIR Publications
%V 8
%N 7
%P e16643
%T A Gamified Smartphone-Based Intervention for Depression: Randomized Controlled Pilot Trial
%A Lukas,Christian Aljoscha
%A Eskofier,Bjoern
%A Berking,Matthias
%+ Department of Clinical Psychology and Psychotherapy, Friedrich-Alexander-University Erlangen-Nuremberg, Naegelsbachstr 25a, Erlangen, 91052, Germany, 49 176 80526686, christian.aljoscha.lukas@fau.de
%K smartphone technology
%K depression
%K cognitive behavioral therapy
%K approach/avoidance
%K gamification
%D 2021
%7 20.7.2021
%9 Original Paper
%J JMIR Ment Health
%G English
%X Background: Available smartphone-based interventions for depression predominantly use evidence-based strategies from cognitive-behavioral therapy (CBT), but patient engagement and reported effect sizes are small. Recently, studies have demonstrated that smartphone-based interventions combining CBT with gamified approach-avoidance bias modification training (AAMT) can foster patient engagement and reduce symptoms of several mental health problems. Objective: Based on these findings, we developed a gamified smartphone-based intervention, mentalis Phoenix (MT-Phoenix), and hypothesized the program would 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 77 individuals with elevated depression scores (Patient Health Questionnaire-9 scores ≥5). Participants were either instructed to train for 14 days with MT-Phoenix or assigned to a waitlist control condition. Engagement with the intervention was measured by assessing usage data. The primary outcome was reduction in depressive symptom severity at postassessment. Results: Data from this pilot trial shows that participants in the intervention group used the smartphone-based intervention for 46% of all days (6.4/14) and reported a significantly greater reduction of depressive symptoms than did participants in the control condition (F1,74=19.34; P=.001), with a large effect size (d=1.02). Effects were sustained at a 3-month follow-up. Conclusions: A gamified smartphone-based intervention 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 3 trial using clinical samples. Moreover, the intervention should be compared to active control conditions. Trial Registration: German Clinical Trial Registry DRKS00012769; https://tinyurl.com/47mw8du7 
%M 34283037
%R 10.2196/16643
%U https://mental.jmir.org/2021/7/e16643
%U https://doi.org/10.2196/16643
%U http://www.ncbi.nlm.nih.gov/pubmed/34283037