No evidence of increased gaming-related problems with long-term use of a video game therapeutic: Exploratory endpoint findings from a randomized controlled trial

Key findings from this study

• The study found that long-term use of Meliora did not increase gaming-related problems, with Gaming Addiction Scale scores actually decreasing from baseline to post-intervention.
• The researchers demonstrate that changes in gaming-related problems were not associated with cumulative hours of intervention use or experienced immersion intensity.
• The authors report that deterioration rates were low and comparable across all study arms, including participants with ≥24 hours of cumulative use.

Overview

This randomized controlled trial examined whether long-term engagement with Meliora, a video game therapeutic for major depressive disorder, was associated with increased gaming-related problems. The intention-to-treat cohort comprised 1,001 adults (mean age 33.4 years, 64% female). The study compared changes in Gaming Addiction Scale scores across three arms: Meliora intervention, treatment-as-usual, and Sham control.

Methods and approach

Researchers assessed Gaming Addiction Scale (GAS-7) scores at baseline and week 12 post-intervention across three study arms. Analyses examined associations between GAS-7 changes and intervention use hours and experienced immersion. The per-protocol completer cohort (≥24 hours use) underwent separate analysis. Deterioration rates from baseline to post-intervention were calculated across all arms.

Results

GAS-7 scores decreased significantly in the Meliora arm (p = 8.1×10⁻⁴) and treatment-as-usual arm (p = 6.0×10⁻⁶), with no change in the Sham arm (p = 0.39). Changes in gaming-related problem scores showed no association with intervention use hours (Meliora: p = 0.17; Sham: p = 0.28) or experienced immersion (Meliora: p = 0.93; Sham: p = 0.19). Deterioration rates remained low and comparable across study arms. Findings in the per-protocol completer cohort corroborated results, demonstrating that higher use did not increase gaming-related problems.

Implications

These findings provide empirical evidence that extended engagement with a video game therapeutic does not increase gaming-related problems when risk mitigation strategies are implemented. The lack of association between use duration and immersion with gaming-related problem escalation suggests that video game formats pose no inherent risk of harm escalation in clinical contexts. This evidence supports video games as a viable medium for digital therapeutics, potentially addressing engagement barriers that compromise clinical effectiveness in conventional digital mental health interventions.

The comparable decreases in gaming-related problems across both active treatment and control conditions indicate that baseline gaming-related concerns may improve naturally or through non-specific intervention effects. The absence of deterioration in even high-use participants provides reassurance to clinical stakeholders concerned about adverse effects from extended video game engagement. Future therapeutic development may leverage video game formats to enhance patient engagement without additional safety monitoring specific to gaming-related harm.

Scope and limitations

This summary is based on the study abstract and available metadata. It does not include a full analysis of the complete paper, supplementary materials, or underlying datasets unless explicitly stated. Findings should be interpreted in the context of the original publication.