Maze-Out: A Serious Game to Enhance Treatment for Eating Disorders. A Randomized Controlled Trial.

IF 4.7 2区医学 Q1 NUTRITION & DIETETICS

International Journal of Eating Disorders Pub Date : 2025-05-19 DOI:10.1002/eat.24458

Maria Mercedes Guala, Aida Bikic, Kim Bul, David Clinton, Anna Mejdal, Helene Nygaard Nielsen, René Klinkby Støving, Anette Søgaard Nielsen

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引用次数: 0

Abstract

Objective: This study evaluated the effectiveness of Maze Out, a serious game (SG) codesigned by patients with eating disorders (ED) and clinicians as an adjunct to treatment as usual (TAU) for improving self-efficacy, self-image, and engagement in individuals with ED. Effects on ineffectiveness, insecurity, and personal recovery were also examined.

Method: A randomized controlled trial (RCT) was conducted at 11 centers in Denmark between July 2022 and December 2023. A total of 133 adult participants (≥ 18 years) with a registered ICD-10 ED diagnosis were randomized (1:1) to receive Maze Out plus TAU or TAU alone for 15 weeks. Assessments were conducted at baseline, 8 and 15 weeks. The primary outcome was self-efficacy, while the secondary outcomes included self-image, feelings of ineffectiveness and insecurity, and personal recovery. Data were analyzed using linear mixed-effects models under both intention-to-treat (ITT) and complete-case approaches.

Results: ITT analysis revealed no significant differences between the groups on primary or secondary outcomes. Complete-case analysis, however, showed significant improvements in personal recovery (mean difference 5.81 [95% CI 0.25-11.37]; p = 0.040) and reductions in negative self-image, including self-blame (-13.06 [-24.18 to -1.95]; p = 0.021) and self-neglect (-14.59 [-28.01 to -1.17]; p = 0.033), in the intervention group. Engagement was high, indicating meaningful interaction with the game.

Discussion: Although no overall effects were found in ITT analyses, improvements in personal recovery and self-image support the potential of Maze Out as a feasible and acceptable adjunct to TAU. Further research should assess long-term and subgroup-specific effects.

Trial registration: ClinicalTrials.gov identifier: NCT05621018, and the protocol was published (Guala, Bikic, Bul, Clinton, Mejdal, et al. 2024).

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迷宫：一个严肃的游戏，以加强治疗饮食失调。随机对照试验。

目的：本研究评估了迷宫游戏的有效性，这是一种由饮食失调（ED）患者和临床医生共同设计的严肃游戏（SG），作为日常治疗（TAU）的辅助手段，可提高ED患者的自我效能、自我形象和参与度。对无效、不安全感和个人康复的影响也进行了研究。方法：于2022年7月至2023年12月在丹麦11个中心进行随机对照试验（RCT）。共有133名注册ICD-10 ED诊断的成人参与者（≥18岁）随机（1:1）接受Maze Out + TAU或单独TAU治疗15周。在基线、8周和15周进行评估。主要结果是自我效能感，次要结果包括自我形象、无效能感和不安全感以及个人恢复。使用意向治疗（ITT）和完整病例方法下的线性混合效应模型分析数据。结果：ITT分析显示各组间主要或次要结局无显著差异。然而，全病例分析显示，个人恢复有显著改善(平均差异5.81 [95% CI 0.25-11.37]；P = 0.040)和消极自我形象的减少，包括自责(-13.06[-24.18至-1.95]；P = 0.021)和自我忽视(-14.59[-28.01至-1.17]；P = 0.033)。用户粘性很高，表明玩家与游戏进行了有意义的互动。讨论：虽然在ITT分析中没有发现总体效果，但在个人恢复和自我形象方面的改善支持了Maze Out作为TAU的可行和可接受的辅助治疗的潜力。进一步的研究应评估长期和亚组特异性效果。试验注册：ClinicalTrials.gov识别码：NCT05621018，试验方案已发表（Guala, Bikic, Bul, Clinton, Mejdal, et al. 2024）。

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来源期刊

International Journal of Eating Disorders 医学-精神病学

CiteScore

10.00

自引率

12.70%

发文量

204

审稿时长

4-8 weeks

期刊介绍： Articles featured in the journal describe state-of-the-art scientific research on theory, methodology, etiology, clinical practice, and policy related to eating disorders, as well as contributions that facilitate scholarly critique and discussion of science and practice in the field. Theoretical and empirical work on obesity or healthy eating falls within the journal’s scope inasmuch as it facilitates the advancement of efforts to describe and understand, prevent, or treat eating disorders. IJED welcomes submissions from all regions of the world and representing all levels of inquiry (including basic science, clinical trials, implementation research, and dissemination studies), and across a full range of scientific methods, disciplines, and approaches.