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Smartphone video games improve cognitive function in patients with chronic schizophrenia: a randomized controlled trial

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Abstract

This study aimed to examine the efficacy of video games in improving cognitive function in chronic patients with schizophrenia and to evaluate the biomarker of video games for cognitive function. The patients in the game group were requested to play single-player video games on their smartphones for 1 h per day, five times a week for 6 weeks. Those in the control group watched television for 1 h per day, five times a week for 6 weeks. Cognitive function was assessed using the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) and Stroop Color and Word Test (SCWT). Clinical symptoms were assessed using the Positive and Negative Syndrome Scale (PANSS), Global Assessment of Functioning (GAF), General Self-Efficacy Scale (GSE), Problematic Mobile Gaming Questionnaire (PMGQ), and Patient Health Questionnaire-9 (PHQ-9). The game group demonstrated improved RBANS total score during the trial. There were no significant group effects among all SCWT scores. The game group demonstrated greater improvement on the PANSS Negative Scale, and global function (GAF score). The PMGQ scores were lower than the cutoff score at all time points in both groups. There were no significant group differences in the PHQ-9 and GSE scores. The serum BDNF levels were significantly higher in the game group following 6 weeks of video game intervention. The BDNF serum levels of all participants were positively associated with the RBANS total scores. This preliminary study suggested that video games can improve cognitive function in schizophrenia patients. Serum BDNF levels may be a suitable biomarker for predicting an improvement in cognitive function in schizophrenia patients.

Trial registration: This study was registered on March 11, 2021 (ChiCTR2100044113).

Clinical trials: Smartphone video games improve cognitive function in patients with chronic schizophrenia; https://www.chictr.org.cn/hvshowproject.aspx?id=95623; ChiCTR2100044113.

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Data availability

The datasets generated by the survey research during and/or analyzed during the current study are available. Researchers may obtain data for this study by contacting the corresponding author.

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Acknowledgements

We thank all of participants who volunteered to participate in the study. Thanks to Chaohu Hospital of Anhui Medical University and corresponding authors for their support.

Funding

This work was supported by the China International Medical Exchange Foundation (grant numbers Z-2018-35-2002), the Anhui Province Outstanding Young Talents Support Program (grant nmuber gxyqZD2022022), and the Anhui Provincial Key R&D Programme (grant numbers 202004j07020030).

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Author notes

  1. Shengya Shi, Shu Cui and Yitan Yao have contributed equally to this work.

Authors and Affiliations

  1. Department of Psychiatry, Chaohu Hospital of Anhui Medical University, 64 North Chaohu Road, Hefei, 238000, China

    Shengya Shi, Yitan Yao, Menglin Ge, Meng Yang, Xuanlian Sheng, Bei Luo, Yating Yang, Xiaoping Yuan, Xiaoqin Zhou, Huanzhong Liu & Kai Zhang

  2. Department of Psychiatry, Fuyang Third People’s Hospital, Fuyang, China

    Shu Cui

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Contributions

SS, SC and YY performed experiments, analyzed data, generated figures. MG, MY, XS and BL provided patient material and discussed data. YY and XY supported data analyses. KZ wrote the manuscript. XZ, HL and KZ designed and cosupervised the study.

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Correspondence to Kai Zhang.

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Shi, S., Cui, S., Yao, Y. et al. Smartphone video games improve cognitive function in patients with chronic schizophrenia: a randomized controlled trial. Eur Arch Psychiatry Clin Neurosci 274, 929–939 (2024). https://doi.org/10.1007/s00406-023-01660-4

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