Can Teens Game Away Their Depression?

By DR. AMAR NARULA

Teenagers seem to be doing everything in front of a computer screen these days - watching movies, homework, socializing. So the idea that a computer game could treat depression in these teens may not sound so far-fetched.

Now, new research suggests that a specially designed computer game may be able to do just that - treating teenagers' depression perhaps even as effectively as a human therapist.

In a new study, researchers at the University of Auckland in New Zealand examined the use of an interactive fantasy game termed SPARX, in which users go through a series of challenges to restore balance in a fantasy world dominated by "gloomy negative automatic thoughts."

The game takes players through seven levels, termed "provinces," which guide them through core skills including finding hope, overcoming problems, and challenging unhelpful thoughts.

The game approach was compared to conventional care, which for most people included face-to-face sessions with trained counselors or psychologists. When adolescents and teens aged 12 to 19 with mild to moderate depression played SPARX over a four- to seven-week period, they experienced a reduction in their scores for common depression that was similar to the reduction seen in teens who had undergone counseling sessions instead.

The researchers also found that 43 percent of the adolescents and teens who played SPARX were no longer depressed by the end of the study period, compared to just 26 percent of their counterparts who received treatment as usual.

The results were published in the British Medical Journal on Thursday.

According to the National Institutes of Mental Health, 11 percent of 13- to 18-year-olds develop depression at some point their adolescence. And for those with mild to moderate depression, the recommended approach to manage this depression is through psychological therapy. One approach that has been shown to be particularly effective is known as cognitive behavioral therapy, which teaches people how to deal with stress and unhealthy thoughts and behaviors.

However, many places don't have the resources to provide this therapy. One study published in 2002 found that nearly 80 percent of children and adolescents in the U.S. who need mental health services don't receive them.

Dr. Harold Koenig, a professor of psychiatry and behavioral sciences at Duke University Medical Center in Durham, N.C., who was not involved in the study, said he was impressed with results.

"In areas that don't have resources - which is most of the world right now, including the U.S. - this program would be very useful," he said. Koenig did, however, offer the caveat that longer term follow-up is needed to see if the results hold up.

Randy Auerbach, director of the Child and Adolescent Mood Disorders Laboratory at McLean Hospital in Belmont, Mass., agreed. "Computerized interventions have the potential of removing many barriers to mental health services, which may facilitate patients receiving treatment at early stages in the development of these debilitating disorders."

However, adjusting to the idea of gaming as therapy may take a while for some. Case in point - while 80 percent of adolescents in the SPARX group would recommend the game to their friends, many more who received conventional therapy - 96 percent - said they would recommend it to others.

Still, mental health experts agreed that when mental health resources are not readily available, this computerized approach may have potential as a widely available tool for adolescents dealing with depression.