The Annex: 148 adults on antidepressants, one phone game, 51% against 19%, and a waitlist doing a lot of the work

The Annex reads the method behind the headline. Today’s: a randomised trial by Josefin Brehmer, Gerhard Andersson and colleagues at Linköping University, published in the Journal of Affective Disorders¹.

The claim. A smartphone game called Fig, offered with optional online therapy modules and a therapist on call, reduced depression and anxiety symptoms in adults who were already taking antidepressants but still felt unwell, PsyPost reported on Thursday¹. The game rewards routines around medication, sleep, meals and exercise by letting players build a virtual world¹.

The sample. 148 adults in Sweden, recruited through social media and paid adverts; average age 40, 82% women; 66% in a current major depressive episode¹. Half got nine weeks of the package at once; the other half waited¹.

The numbers. About 51% of the treatment group improved their depression score by at least 30%, against 19% on the waitlist; only 16% improved by at least 50%¹. Medication adherence improved slightly, quality of life did not differ, and 69% of survey respondents were fairly or very satisfied¹. How much people used the game was not linked to how much they improved¹.

The fine print. Some 41% of the treatment group did not complete the post-treatment assessment, against 18% of controls¹. Everyone knew which group they were in, all outcomes were self-reported, 21% of the treatment group never installed the game, and the trial was registered after recruitment had begun¹. The developer, Mindforce Game Lab, funded the study; the authors say it played no part in the analysis¹. The adherence result weakened under the most conservative handling of dropouts¹.

For you. A waitlist is the kindest possible rival: doing something usually beats doing nothing. The authors themselves say the effects cannot be credited to the game rather than the whole package¹. If your medication only half works, that is worth raising with your doctor; a structured routine and access to a therapist are the parts of this package you can ask for today.