ReviewJMIR mental health2021
Examining the Effectiveness of Gamification in Mental Health Apps for Depression: Systematic Review and Meta-analysis.
Review in JMIR mental health, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 38 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
38 citing papers in PubMed, 2 syntheses or guidelines pooled it, 86 citations in OpenAlex.
- Analyzing metaverse-based digital therapies, their effectiveness, and potential risks in mental healthcare.Scientific reports · 2025Pooled it
- Could the use of web-based applications assist in neuropsychiatric treatment? An umbrella review.BMC psychology · 2025Pooled it
- Trial
- An App-Based Cognitive Behavioral Therapy Program Tailored for College Students: Randomized Controlled Trial.JMIR mHealth and uHealth · 2025Trial
- Impact of Conversational and Animation Features of a Mental Health App Virtual Agent on Depressive Symptoms and User Experience Among College Students: Randomized Controlled Trial.JMIR mental health · 2025Trial
- Gamification of Cognitive Behavioral Therapy Homework: Therapist Concept Mapping Approach.JMIR formative research · 2026Article
- Improving adherence to an online intervention for low mood by a virtual coach or personalized motivational feedback messages: A three-arm pilot randomized controlled trial.Internet interventions · 2026Article
- Engaging veterans in the development of mobile health interventions to support medication treatment for opioid use disorder.Frontiers in digital health · 2026Article
- My Cosmos: development, clinical protocol, and preliminary usability of a gamified transdiagnostic digital CBT platform.Frontiers in psychiatry · 2026Article
- Investigating the Role of Situational Disruptors in Engagement with Digital Mental Health Tools.CSCW : proceedings of the Conference on Computer-Supported Cooperative Work. Conference on Computer-Supported Cooperative Work · 2025Article
- What influences engagement with a bipolar disorder self-management app? A qualitative investigation of use of the PolarUs app.PLOS digital health · 2025Article
- Improvement of Game Users' Depressive Symptoms via Behavioral Activation in a Massive Multiplayer Online Game: Randomized Controlled Trial.JMIR serious games · 2025Article
- Exploring the Requirements for an mHealth App to Prevent and Manage Perinatal Anxiety and Depression.Health science reports · 2025Article
- Therapy Companion Mobile App for Acceptance and Commitment Therapy Exercises (ACTaide): Therapist and Client Co-Design Study.JMIR formative research · 2025Article
- Gamification as a Tool for Understanding Mental Disorders in Nursing Students: Qualitative Study.JMIR nursing · 2025Article
- Digital Mental Health Interventions for Adolescents and Young People: Evaluating Efficacy and Accessibility.Cureus · 2025Review
- Digital wellness or digital dependency? a critical examination of mental health apps and their implications.Frontiers in psychiatry · 2025Article
- The regulatory status of health apps that employ gamification.Scientific reports · 2024Article
- Nudges and Prompts Increase Engagement in Self-Guided Digital Health Treatment for Depression and Anxiety: Results From a 3-Arm Randomized Controlled Trial.JMIR formative research · 2024Article
- Promoting Physical and Mental Health among Children and Adolescents via Gamification-A Conceptual Systematic Review.Behavioral sciences (Basel, Switzerland) · 2024Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPrevious research showed that computerized cognitive behavioral therapy can effectively reduce depressive symptoms. Some mental health apps incorporate gamification into their app design, yet it is unclear whether features differ in their effectiveness to reduce depressive symptoms over and above mental health apps without gamification.
objectiveThe aim of this study was to determine whether mental health apps with gamification elements differ in their effectiveness to reduce depressive symptoms when compared to those that lack these elements.
methodsA meta-analysis of studies that examined the effect of app-based therapy, including cognitive behavioral therapy, acceptance and commitment therapy, and mindfulness, on depressive symptoms was performed. A total of 5597 articles were identified via five databases. After screening, 38 studies (n=8110 participants) remained for data extraction. From these studies, 50 total comparisons between postintervention mental health app intervention groups and control groups were included in the meta-analysis.
resultsA random effects model was performed to examine the effect of mental health apps on depressive symptoms compared to controls. The number of gamification elements within the apps was included as a moderator. Results indicated a small to moderate effect size across all mental health apps in which the mental health app intervention effectively reduced depressive symptoms compared to controls (Hedges g=-0.27, 95% CI -0.36 to -0.17; P<.001). The gamification moderator was not a significant predictor of depressive symptoms (β=-0.03, SE=0.03; P=.38), demonstrating no significant difference in effectiveness between mental health apps with and without gamification features. A separate meta-regression also did not show an effect of gamification elements on intervention adherence (β=-1.93, SE=2.28; P=.40).
conclusionsThe results show that both mental health apps with and without gamification elements were effective in reducing depressive symptoms. There was no significant difference in the effectiveness of mental health apps with gamification elements on depressive symptoms or adherence. This research has important clinical implications for understanding how gamification elements influence the effectiveness of mental health apps on depressive symptoms.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.