Awareness, Prevention, Detection, and Therapy Applications for Depression and Anxiety in Serious Games: Systematic Review

Serious games serve as an increasingly viable clinical intervention for addressing depression and anxiety in children and adolescents. By analyzing 34 studies published between 2015 and 2020, it becomes clear that the current landscape is heavily weighted toward prevention and therapy, which account for 44 percent and 32 percent of applications, respectively. These interventions predominantly target the 11 to 14 age demographic, utilizing arcade-style minigames and adventure worlds to facilitate emotional regulation and symptom reduction. While these tools demonstrate significant potential, the field currently lacks a cohesive framework for development and assessment.

The prevailing reliance on pre-post evaluation via normalized questionnaires creates a fragmented evidence base, complicating direct comparisons of clinical effectiveness across different studies. Most games are designed for PC platforms with session lengths typically under one hour, yet there is a notable absence of standardized design theories. This inconsistency hinders the ability to scale these solutions or verify their long-term impact on mental health outcomes. Furthermore, there is a distinct gap in the availability of games specifically designed for awareness and early detection, which are essential components of a comprehensive mental health strategy.

Future advancements in this sector require a shift toward more rigorous, multi-modal data collection. Integrating in-game behavioral analytics with traditional psychological assessments will provide a more nuanced understanding of user progress and engagement. Additionally, the industry must prioritize the adoption of virtual reality technology and ensure a more balanced distribution of interventions across diverse age groups and specific mental health conditions. Establishing standardized design and evaluation protocols is critical to transforming these serious games from experimental tools into reliable, evidence-based components of modern clinical practice.