A prespecified secondary analysis of an RCT tested whether a codesigned digital behavioral health game (PlaySmart, ~300 minutes over 6 weeks) reduced depressive (PHQ-8) and anxiety (GAD-7) symptoms versus an attention-matched active control in 532 adolescents (ages 16–19) recruited from 15 school-based health programs in Connecticut, with follow-up through 12 months.
At 12 months, the intervention group had significantly lower PHQ-8 scores than controls (adjusted mean 5.30 vs. 6.42; adjusted difference −1.12 points [95% CI, −1.85 to −0.38]; Cohen d = 0.21). No significant effect was found for GAD-7. At 6 weeks, intervention participants had higher beliefs about psychological services (BAPS; adjusted difference +0.03 [95% CI, 0.01–0.05]), and early BAPS gains partially mediated PHQ-8 reductions at 6 months.
- Depressive and anxiety symptoms were prespecified secondary outcomes; the trial was not powered for them, so small subgroup differences may be undetected. - All outcomes were self-reported, introducing potential response bias. - Mediation and moderation analyses were exploratory and post hoc, requiring replication in pre-registered studies.
A school-based digital behavioral health game delivered in about 5 hours over 6 weeks was linked to modest but sustained reductions in depressive symptoms over 12 months in a diverse adolescent population. Clinicians and school health programs may consider such low-burden digital tools as a scalable complement to existing mental health services, particularly for adolescents with barriers to traditional care.
Explore related topics
