TY  - JOUR
AU  - Yatziv, Shai-Lee
AU  - Pedrelli, Paola
AU  - Baror, Shira
AU  - DeCaro, Sydney Ann
AU  - Shachar, Noam
AU  - Sofer, Bar
AU  - Hull, Sunday
AU  - Curtiss, Joshua
AU  - Bar, Moshe
PY  - 2024
DA  - 2024/11/7
TI  - Facilitating Thought Progression to Reduce Depressive Symptoms: Randomized Controlled Trial
JO  - J Med Internet Res
SP  - e56201
VL  - 26
KW  - depression
KW  - cognitive neuroscience
KW  - facilitating thought progression
KW  - FTP
KW  - mobile phone
KW  - digital health
KW  - gamification
KW  - depression symptoms
KW  - randomized controlled trial
KW  - RCT
KW  - app
KW  - depressive disorder
KW  - web-based platforms
KW  - effectiveness
AB  - Background: The constant rise in the prevalence of major depressive disorder calls for new, effective, and accessible interventions that can rapidly and effectively reach a wide range of audiences. Recent developments in the digital health domain suggest that dedicated online platforms may potentially address this gap. Focusing on targeting ruminative thought, a major symptomatic hallmark of depression, in this study we hypothesized that delivering a digital health–based intervention designed to systematically facilitate thought progression would substantially alleviate depression. Objective: The study aims to investigate the efficacy of a novel digital intervention on the reduction of depressive symptoms. This intervention was designed as an easy-to-use gamified app specifically aimed to facilitate thought progression through intense practicing of associative, semantically broad, fast, and creative thought patterns. Methods: A randomized clinical trial was conducted, comparing changes in depression symptoms between participants who used the app in the intervention group (n=74) and waitlist control group (n=27) over the course of 8 weeks. All participants filled out a battery of clinical questionnaires to assess the severity of depression at baseline and 4 and 8 weeks after starting the study. These primarily included the Montgomery-Åsberg Depression Rating Scale (MADRS) and the Patient Health Questionnaire-9 as well as the Positive Affect Negative Affect Scale-Negative Affect Score, Ruminative Response Scale, and Symptoms of Depression Questionnaire. Additional questionnaires were implemented to assess anxiety, positive affect, anhedonia, and quality of life. Results: The results indicate that across multiple clinical measurements, participants in the intervention group who played the gamified app showed greater and faster improvement in depressive symptoms compared with their waitlist control counterparts. The difference between the groups in MADRS improvement was –7.01 points (95% CI –10.72 to –3.29; P<.001; Cohen d=0.67). Furthermore, the difference in improvement between groups persisted up to 4 weeks posttrial (MADRS differences at week 12: F49,2=6.62; P=.003; ηp2=0.21). At the end of the trial, participants who played the app showed high interest in continuing using the app. Conclusions: The results demonstrate that a gamified app designed to facilitate thought progression is associated with improvement in depressive symptoms. Given its innovative and accessibility features, this gamified method aiming to facilitate thought progression may successfully complement traditional treatments for depression in the future, providing a safe and impactful way to enhance the lives of individuals experiencing depression and anxiety. Trial Registration: ClinicalTrials.gov NCT05685758; https://clinicaltrials.gov/study/NCT05685758 
SN  - 1438-8871
UR  - https://www.jmir.org/2024/1/e56201
UR  - https://doi.org/10.2196/56201
DO  - 10.2196/56201
ID  - info:doi/10.2196/56201
ER  -