Cognitive trainings using video games might increase subjective well-being of individuals with depression

A study conducted in Germany revealed that playing the 3D video game “Super Mario Odyssey” resulted in a more significant reduction in depression symptoms compared to participants who used a cognitive training computer program (“CogPack”) or underwent standard treatments for these symptoms. The study, published in Frontiers in Psychiatry, also found that participants in the 3D video game group exhibited higher levels of training motivation.

Human mental processes have two important aspects. One is cognition, the set of mental processes encompassing activities such as perception, memory, problem-solving, and decision-making. It involves the acquisition, storage, processing, and utilization of information in the mind. The other one is affect. Affect represents the emotional dimension of mental life, the subjective experience of emotions and moods. Affect is expressed through facial expressions, body language, and tone of voice. It plays an important role in shaping an individual’s responses and interactions with their environment.

When studying depression or major depressive disorder, researchers most often focus on its affective symptoms. These include persistent feelings of sadness, emptiness, and hopelessness, accompanied by a diminished ability to experience pleasure or interest in activities once found enjoyable.

However, this disorder is also accompanied by cognitive dysfunctions such as persistent negative thoughts, self-criticism, difficulty concentrating, and impaired decision-making. Unlike affective symptoms, cognitive symptoms of depression can often persist even after affective symptoms have withdrawn.

Study author Moritz Bergmann and his colleagues wanted to investigate whether a six-week video game intervention leads to improvements in depressed mood, training motivation, and visuo-spatial memory functions in individuals with major depressive disorder. They compared the effects of playing the video game “Super Mario Odyssey” on a Nintendo Switch console with the effects of a cognitive training program “CogPack” and usual treatments for this disorder.

Free daily newsletter

The game “Super Mario Odyssey” requires participants to navigate within 3D environments while relying on processes that depend on the hippocampus region of the brain. In this way, it could potentially influence performance on hippocampally-mediated memory tasks, specifically visuo-spatial memory.

The study involved 46 individuals diagnosed with depression who reported infrequent video game play in their leisure time. These participants were randomly divided into three groups: one playing “Super Mario Odyssey,” one using the “CogPack” program, and one receiving standard clinical treatment, which included medication and psychotherapy.

At the beginning and end of the study, participants underwent assessments of depression symptoms (using Becks Depression Inventory, BDI-II), motivation to participate in the cognitive training (assessed through one question), and visuo-spatial learning and memory (evaluated using the Wechsler memory scale – block tapping and the Brief Visual Memory Test-Revised).

Results showed that the percentage of participants with high levels of depressive symptoms decreased the most in the “Super Mario Odyssey” group. Their number almost halved. The decreases in the other two groups were smaller and insufficient to exclude the possibility that they were due to random variations in answers instead of treatment effects.

Participants assigned to play “Super Mario Odyssey” reported higher motivation for treatment compared to those in the “CogPack” group. Visuo-spatial memory scores improved most notably in the “CogPack” group. One of the memory tests showed a smaller improvement in the “Super Mario Odyssey” group compared to the “CogPack,” while the other test did not show any memory improvement in the “Super Mario Odyssey” group. Participants undergoing standard treatments for depression showed no improvement in memory.

“Results indicate that after six weeks of training the 3D video gaming group [the ‘Super Mario Odyssey’ group] showed a significant decrease in the proportion of participants with clinically significant levels of depressive symptoms by self-report and a higher mean training motivation when compared with the active control group,” the study authors concluded.

“Furthermore, results suggest significant improvements in tasks of visuo-spatial (working) memory performance during post-testing in both training groups, however, the 3D video gaming group demonstrates more selective improvements and does not perform significantly better than the other two groups. Still, these mixed findings suggest that video game training may be a cost-effective and feasible intervention for patients with MDD that can be used in conjunction with regular treatment and therapy.”

The study makes a valuable contribution to understanding the effects of video games on symptoms of depression. However, it was not a blind study; participants were aware of their assigned group and could likely infer the research focus, potentially biasing the results. Additionally, the sample size was small, which may limit the generalizability of the findings.

The paper, “Effects of a video game intervention on symptoms, training motivation, and visuo-spatial memory in depression”, was authored by Moritz Bergmann, Ines Wollbrandt, Lisa Gittel, Eva Halbe, Sarah Mackert, Alexandra Philipsen, and Silke Lux.