Juegos serios para el tratamiento o la prevención de la depresión: una revisión sistemática

Serious games (computerised interventions which utilise gaming for serious purposes) have been shown to support improved outcomes in several health conditions. We aimed to review evidence regarding serious games for depression. We undertook electronic searches of PsycInfo, EMBASE and Medline, using terms relevant to computer games and depression. We included fulltext articles published in English in peer-reviewed literature since 2000, where the intervention was designed to treat or prevent depression and which included pre-and post-intervention measurement of depression. Nine studies relating to a total of six interventions met inclusion criteria. Most studies were small and were carried out by the developers of the programs. All were tested with young people (ages between 9 and 25 years). Most reported promising results with some positive impact on depression although one universal program had mixed results. Serious gaming interventions show promise for depression, however evidence is currently very limited.Se ha demostrado que los juegos serios (intervenciones computarizadas que utilizan juegos) mejoran los resultados en diferentes problemas de salud. Pretendemos examinar las evidencias de estos juegos para la depresión. Se realizaron búsquedas electrónicas en PsycINFO, EMBASE y Medline usando términos relacionados con juegos de ordenador y depresión. Se incluyeron artículos publicados desde el año 2000, donde se diseñó la intervención para tratar o prevenir la depresión incluyendo medidas pre- y post-intervención. Nueve estudios sobre un total de seis intervenciones cumplieron los criterios de inclusión. La mayoría de estos fueron pequeños y los llevaron a cabo los desarrolladores de los programas. Todos incluían población joven (9 - 25 años). La mayoría presentan resultados prometedores con un impacto positivo sobre la depresión aunque un programa universal tuvo resultados mixtos. Se concluye que las intervenciones basadas en juegos serios son prometedoras para la depresión, aunque la evidencia es todavía muy limitada

SERIOUS GAMES FOR THE TREATMENT OR PREVENTION OF DEPRESSION: A SYSTEMATIC REVIEW

Abstract: Serious games (computerised interventions which utilise gaming for serious purposes) have been shown to support improved outcomes in several health conditions. We aimed to review evidence regarding serious games for depression. We undertook electronic searches of PsycInfo, EMBASE and Medline, using terms relevant to computer games and depression. We included fulltext articles published in English in peer-reviewed literature since 2000, where the intervention was designed to treat or prevent depression and which included pre-and post-intervention measurement of depression. Nine studies relating to a total of six interventions met inclusion criteria. Most studies were small and were carried out by the developers of the programs. All were tested with young people (ages between 9 and 25 years). Most reported promising results with some positive impact on depression although one universal program had mixed results. Serious gaming interventions show promise for depression, however evidence is currently very limited. Keywords: Depression; adolescents; computerised CBT; serious gaming; e-therapy. Juegos serios para el tratamiento o la prevención de la depresión: una revisión sistemática Resumen: Se ha demostrado que los juegos serios (intervenciones computarizadas que utilizan juegos) mejoran los resultados en diferentes problemas de salud. Pretendemos examinar las evidencias de estos juegos para la depresión. Se realizaron búsquedas electrónicas en PsycINFO, EMBA-SE y Medline usando términos relacionados con juegos de ordenador y depresión. Se incluyeron artículos publicados desde el año 2000, donde se diseñó la intervención para tratar o prevenir la depresión incluyendo medidas pre-y post-intervención. Nueve estudios sobre un total de seis intervenciones cumplieron los criterios de inclusión. La mayoría de estos fueron pequeños y los llevaron a cabo los desarrolladores de los programas. Todos incluían población joven (9 -25 años). La mayoría presentan resultados prometedores con un impacto positivo sobre la depresión aunque un programa universal tuvo resultados mixtos. Se concluye que las intervenciones basadas en juegos serios son prometedoras para la depresión, aunque la evidencia es todavía muy limitada

O is for Awesome : National Survey of New Zealand School-Based Well-being and Mental Health Interventions

Although student well-being and mental health are government-identified responsibilities for New Zealand schools, the extent to which school-based well-being and mental health interventions are currently delivered is unknown. This survey of a nationally representative sample of schools was undertaken to identify: what well-being and mental health interventions are currently used by primary (elementary) and secondary (high) schools; what gaps exist between current practice and the evidence base; what ideas staff have for improving student well-being and mental health; and what barriers staff can identify for implementing evidence-based interventions and suggestions for how these may be overcome. Forty staff from 37 (22 primary, 13 secondary and 2 composite) schools participated in semi-structured interviews. Seven key themes were identified: (1) awareness and enthusiasm about student well-being and mental health; (2) existence of specific interventions to support student well-being and mental health; (3) support for government-sponsored programmes; (4) limitations of existing programmes; (5) drivers of new interventions; (6) perceived barriers to the implementation of new interventions; and (7) suggestions for future interventions and their implementation. Currently, a wide range of primarily non-evidence based well-being and mental health interventions are delivered in a variable manner by school-based and external providers. Despite current enthusiasm by schools, there is room for improvement in the quality and equity of intervention delivery

The role of gamification in digital mental health

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Immersive Reality Experience Technology for Reducing Social Isolation and Improving Social Connectedness and Well-being of Children and Young People Who Are Hospitalized: Open Trial

BackgroundChildren and young people who are hospitalized can feel disconnected from their peers and families, which can, in turn, predispose them to psychological problems, including anxiety and depression. Immersive reality experience technology, recently developed by the New Zealand Patience Project Charitable Trust, may help to overcome these issues. Immersive reality experience technology uses immersive 360° live streaming and a virtual reality headset to enable children and young people who are hospitalized to connect through cameras located in either their school or home environment and via SMS text messaging with a designated buddy. ObjectiveThis trial aims to expand qualitative findings from a previous smaller proof of concept trial to ascertain the views of New Zealand children and young people who are hospitalized, their caregivers, and teachers regarding immersive reality experience technology and quantitatively evaluate the effectiveness of immersive reality experience technology in reducing social isolation and improving social connectedness and well-being using validated outcome measures. MethodsAn open trial of immersive reality experience technology was conducted between December 2019 and December 2020 for which 19 New Zealand children and young people aged 13 to 18 years who had been hospitalized at Starship Hospital—a specialist pediatric hospital in Auckland—for at least 2 weeks were recruited. All young people completed the Short Warwick–Edinburgh Mental Well-Being Scale, an abbreviated version of the Social Connectedness Scale, and the Social Inclusion Scale at baseline. Of the 19 participants, 10 (53%) used immersive reality experience technology as often as they wished over a 6-week period and completed postintervention measures. Semistructured interviews with a subset of the 10 young people, 4 caregivers, and 6 teachers were conducted immediately after the intervention. ResultsParticipants reported improvements in social inclusion (mean change 3.9, SD 2.8; P=.06), social connectedness (mean change 14.2, SD 10.0; P=.002), and well-being (mean change 5.7, SD 4.0; P=.001). Key themes from interviews with participants, caregivers, and teachers were the importance of support for using immersive reality experience technology, connecting versus connectedness, choice and connection, and the value of setting it up and getting it right. Recommendations for improving connectedness via immersive reality experience and related technologies were also provided. ConclusionsImmersive reality experience technology can improve the social inclusion, social connectedness, and well-being of New Zealand children and young people who are hospitalized. With some technological modifications and simplified implementation, immersive reality experience and related technology could become part of standard care and support children and young people who are hospitalized in New Zealand and elsewhere to sustain family and peer cohesion, experience fewer psychological problems, and more easily return to normal life following the completion of treatment. Trial RegistrationAustralian New Zealand Clinical Trials Network Registry ACTRN12619000252112; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=376837&isReview=tru

Co-design of eHealth Interventions With Children and Young People

Co-design, defined as collective creativity across the entire design process, can lead to the development of interventions that are more engaging, satisfying, and useful to potential users. However, using this methodology within the research arena requires a shift from traditional practice. Co-design of eHealth interventions with children and young people has additional challenges. This review summarizes the applied core principles of co-design and recommends techniques for undertaking co-design with children and young people. Three examples of co-design during the development of eHealth interventions (Starship Rescue, a computer game for treating anxiety in children with long-term physical conditions, a self-monitoring app for use during treatment of depression in young people, and HABITS, the development of an emotional health and substance use app, and eHealth platform for young people) are provided to illustrate the value and challenges of this contemporary process

A Cognitive Behavioral Therapy–, Biofeedback-, and Game-Based eHealth Intervention to Treat Anxiety in Children and Young People With Long-Term Physical Conditions (Starship Rescue): Co-design and Open Trial

BackgroundApproximately 10%-12% of New Zealand children and young people have long-term physical conditions (chronic illnesses) and are more likely to develop psychological problems, particularly anxiety and depression. Delayed treatment leads to worse health care and poorer long-term outcomes. Recently, eHealth interventions, especially those based on principles of cognitive behavioral therapy and biofeedback, have been shown to be moderately effective in reducing anxiety. However, these modalities have rarely been combined. Young people have expressed a preference for well-designed and technology-based support to deal with psychological issues. ObjectiveThis study aims to co-design and evaluate the acceptability and usability of a cognitive behavioral therapy and biofeedback-based, 5-module eHealth game called Starship Rescue and to provide preliminary evidence regarding its effectiveness in addressing anxiety and quality of life in young people with long-term physical conditions. MethodsStarship Rescue was co-designed with 15 children and young people from a tertiary hospital in New Zealand. Following this, 24 others aged 10-17 years participated in an open trial of the game, accessing it over an 8-week period. The acceptability of the game to all participants was assessed using a brief, open-ended questionnaire. More detailed feedback was obtained from a subset of 10 participants via semistructured interviews. Usability was evaluated via device-recorded frequency and duration of access on completion of the game and the System Usability Scale. Anxiety levels were measured at baseline, completion, and 3 months after completion of the game using the Generalized Anxiety Disorder 7-item scale and Spence Child Anxiety Scale, and at the start of each module and on completion using an embedded Likert visual analog scale. Quality of life was measured at baseline, completion, and 3 months after completion using the Pediatric Quality of Life Inventory scale. ResultsUsers gave Starship Rescue an overall rating of 5.9 out of 10 (range 3-10) and a mean score of 71 out of 100 (SD 11.7; minimum 47.5; maximum 90) on the System Usability Scale. The mean period for the use of the game was just over 11 weeks (78.8 days, 13.5 hours, 40 minutes). Significant reductions in anxiety were noted between the start and end of the game on the Generalized Anxiety Disorder 7-item scale (−4.6; P<.001), Spence Child Anxiety Scale (−9.6; P=.005), and the Likert visual analog scales (−2.4; P=.001). Quality of life also improved on the Pediatric Quality of Life Inventory scale (+4.3; P=.04). All changes were sustained at the 3-month follow-up. ConclusionsThis study provides preliminary evidence for Starship Rescue as an acceptable, usable, and effective eHealth intervention for treating anxiety in young people with long-term physical conditions. Further evaluation is planned via a randomized controlled trial. Trial RegistrationAustralian New Zealand Clinical Trials Network Registry (ANZCTR) ACTRN12616001253493; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=37144

Is it time for child psychiatry to grow up?

Gone are the days when children were seen and not heard. However, their mental health needs continue to be underserved in Australia and New Zealand. Currently, there are 386 accredited members of the Faculty of Child and Adolescent Psychiatry in Australia and 46 in New Zealan

Screening for risky behaviour and mental health in young people: the YouthCHAT programme

Abstract Background The prevalence of mental health concerns and risky health behaviours among young people is of global concern. A large proportion of young people in New Zealand (NZ) are affected by depression, suicidal ideation and other mental health concerns, but the majority do not access help. For NZ indigenous Māori, the burden of morbidity and mortality associated with mental health is considerably higher. Targeted screening for risky behaviours and mental health concerns among youth in primary care settings can lead to early detection and intervention for emerging or current mental health and psychosocial issues. Opportunistic screening for youth in primary care settings is not routinely undertaken due to competing time demands, lack of context-specific screening tools and insufficient knowledge about suitable interventions. Strategies are required to improve screening that are acceptable and appropriate for the primary care environment. This article outlines the development, utilisation and ongoing evaluation and implementation strategies for YouthCHAT. YouthCHAT YouthCHAT is a rapid, electronic, self-report screening tool that assesses risky health-related behaviours and mental health concerns, with a ‘help question’ that enables youth to prioritise areas they want help with. The young person can complete YouthCHAT in the waiting room prior to consultation, and after completion, the clinician can immediately access a summary report which includes algorithms for stepped-care interventions using a strength-based approach. A project to scale up the implementation is about to commence, using a co-design participatory research approach to assess acceptability and feasibility with successive roll-out to clinics. In addition, a counter-balanced randomised trial of YouthCHAT versus clinician-administered assessment is underway at a NZ high school. Conclusion Opportunistic screening for mental health concerns and other risky health behaviours during adolescence can yield significant health gains and prevent unnecessary morbidity and mortality. The systematic approaches to screening and provision of algorithms for stepped-care intervention will assist in delivering time efficient, early, more comprehensive interventions for youth with mental health concerns and other health compromising behaviours. The early detection of concerns and facilitation to evidence-based interventions has the potential to lead to improved health outcomes, particularly for under-served indigenous populations