Effects of game-based digital therapeutics on attention deficit hyperactivity disorder in children and adolescents as assessed by parents or teachers: a systematic review and meta-analysis

Oh, SuA; Choi, Jina; Han, Doug Hyun; Kim, Eun Young

doi:10.1007/s00787-023-02174-z

Cited by 8 publications

(3 citation statements)

References 61 publications

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“…DTx are also easily scalable, can serve as adjunct to standard care, improve treatment fidelity [33][34][35], are cost-effective [36]. These technologies have been shown to be preliminarily effective in treating adolescents with a variety of mental health concerns including attention-deficit/hyperactivity disorder [37], sleep disorders, eating disorders, and anxiety [38]. Ultimately, DTx fill critical gaps in non-DTx digital treatments and can help patients receive effective, data-driven treatment with the added benefit of home access at any time [35,39,40].…”

Section: Introductionmentioning

confidence: 99%

Preliminary Efficacy of a Digital Intervention for Adolescent Depression: Randomized Controlled Trial

Peake,

Miller,

Flannery

et al. 2024

J Med Internet Res

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Background Adolescent depression is a significant public health concern; however, access to effective mental health care is limited. Digital therapeutics (DTx) can improve access to evidence-based interventions; however, their efficacy in adolescents is sparsely documented. Objective This study aims to examine the efficacy of a mobile app DTx versus an active control as an adjunct treatment for adolescent depression symptoms. Methods An internet-based open-label randomized control trial was conducted nationwide with a partial crossover design, and 168 adolescents aged 13 to 21 years with symptoms of depression were recruited between November 2020 and September 2021. Participants were randomized (1:1) to the cognitive behavioral therapy–based treatment app (Spark) or to a psychoeducational control app (control), which they would use for a duration of 5 weeks. The primary outcome was a between-group (Spark vs control) difference in the change in depression symptoms from baseline to postintervention, as measured by the Patient Health Questionnaire-8 (PHQ-8) using a linear mixed-effects analysis. The PHQ-8 ranges from 0 to 24, with scores of 5 to 9 indicating mild depression symptoms, scores of 10 to 14 indicating moderate symptoms, scores of 15 to 19 indicating moderately severe symptoms, and scores of 20 to 24 indicating severe symptoms. A minimal clinically important difference (5-point reduction between baseline and postintervention) in the Spark arm and group differences in remission and treatment response rates based on the PHQ-8 at postintervention were also investigated. Results A total of 160 participants were randomized, 80 in the Spark arm (mean age 16.89, SD 2.5 y) and 80 in the control arm (mean age 16.79, SD 2.59 y). Data from 121 participants (Spark: n=63; control: n=58) with moderate to severe (PHQ-8≥10) symptoms at baseline were included in the primary analyses following a modified intention-to-treat principle. A linear mixed-effect analysis revealed a nonsignificant difference between the study arms in depression symptom change over the intervention period. The Spark arm met a minimal clinically important difference threshold (mean −5.08, 95% CI −6.72 to −3.42). The remission rate in the Spark arm was significantly higher than that in the control arm (11/63, 17% vs 2/58, 3%; χ21=6.2; P=.01; false discovery rate–adjusted P=.03). The treatment response rates were not significantly different between the study arms (P=.07; false discovery rate–adjusted P=.16). Post hoc analyses including participants with mild to severe (PHQ-8 score ≥5) symptoms at baseline revealed promising evidence that Spark is effective in those with mild to severe symptoms. Conclusions There is initial evidence that a self-guided, cognitive behavioral therapy–based DTx intervention may effectively treat mild to severe depression symptoms in adolescents. DTx may improve access to mental health care for adolescents or serve as an important adjunct to the standard of care. Trial Registration ClinicalTrials.gov NCT04524598; https://clinicaltrials.gov/study/NCT04524598

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Section: Introductionmentioning

confidence: 99%

Preliminary Efficacy of a Digital Intervention for Adolescent Depression: Randomized Controlled Trial

Peake,

Miller,

Flannery

et al. 2024

J Med Internet Res

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“…Therefore, the timely identification and implementation of suitable interventions are of the utmost significance in mitigating long-term consequences and promoting well-being. There is growing anticipation among numerous experts that XR will demonstrate enhanced efficacy, specifically for adolescents and young adults [ 12 , 21 ] since XR’s optimization overcomes time and place limitations and immerses in therapeutic interventions. Furthermore, the present generation of adolescents and young adults exhibits unprecedented familiarity with digital devices.…”

Section: Introductionmentioning

confidence: 99%

Systematic Review of Extended Reality Digital Therapy for Enhancing Mental Health Among South Korean Adolescents and Young Adults

Lee,

Yoon,

Cho

et al. 2023

J Korean Acad Child Adolesc Psychiatry

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Digital therapy using extended reality (XR) holds great promise for addressing the mental health needs of adolescents and young adults. This study addresses a notable research gap in South Korea by systematically reviewing XR-based digital therapy for the mental health of South Korean adolescents and young adults. We analyzed 26 studies encompassing various aspects, including study type, publication date, research field, research methodology, data sources, program types, program content, sample characteristics, target population, assessment tools, and program effectiveness. Notably, 46.15% of the studies employed an experimental design, whereas over 53% utilized non-experimental approaches. Experimental studies lacked a genuine design, standardized questionnaires, and control variables. Similarly, non-experimental studies failed to report specific literature selection criteria. Consequently, future studies should adopt rigorous methodologies to enhance reliability and validity. Moreover, over 85% of the 26 studies focused solely on virtual reality and did not incorporate augmented or mixed reality. This study identifies the limitations of the previous research. These findings emphasize the need for structured investigations to advance the development of XR-based digital therapy to promote mental health in adolescents and young adults in South Korea.

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“…Thanks to DHT, health can be monitored, diagnosed and treated in innovative and efficient ways ( 2 , 3 ). Digital technologies are used to control asthma and COPD ( 4 ), to treat ADHD ( 5 ), to improve sleep quality ( 6 ), to treat low back pain ( 7 ), to manage type 2 diabetes ( 8 ), for improving executive function and emotional adjustment in the rehabilitation of traumatic brain injury ( 9 ) for monitoring substance use disorders ( 10 ) and for the early detection of acute kidney injury (AKI) ( Shi et al ). This non-exhaustive list of digital therapies shows the wide, varied and hypothetically boundless spectrum in which the development and use of DHT can implement health.…”

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confidence: 99%

Editorial: Equitable digital medicine and home health care

De Micco,

De Benedictis,

Lettieri

et al. 2023

Front. Public Health

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Effects of game-based digital therapeutics on attention deficit hyperactivity disorder in children and adolescents as assessed by parents or teachers: a systematic review and meta-analysis

Cited by 8 publications

References 61 publications

Preliminary Efficacy of a Digital Intervention for Adolescent Depression: Randomized Controlled Trial

Preliminary Efficacy of a Digital Intervention for Adolescent Depression: Randomized Controlled Trial

Systematic Review of Extended Reality Digital Therapy for Enhancing Mental Health Among South Korean Adolescents and Young Adults

Editorial: Equitable digital medicine and home health care

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