Embedded Narrative in Interactive Game Design for Improving Medication Adherence of Schizophrenia

Not Applicable

Suspended

• Conditions: Mental Health Issue; Medication Adherence; Gamification; Schizophrenia and Related Disorders

• Registration Number: NCT06175559
• Lead Sponsor: Zhu Dian

Brief Summary

This study explores the potential of an interactive narrative game to enhance medication adherence among stable schizophrenia patients. Employing participatory design methods, game's development and testing process actively involved patients and individuals closely connected to their daily lives. Artificial Intelligence-Generated Content (AIGC) facilitated swift iterations in game's visual style and content. During game therapy, patients are tasked with making decisions based on presented situations, which influence the course of the narrative.

Detailed Description

Our game design is inspired by Cognitive Behavioral Therapy (CBT), specifically the autonomic engagement and emotion regulation for the treatment of stable schizophrenic patients. This design aims to motivate patients to practice the basic principles of CBT in a virtual environment with the aim of producing positive psychological and behavioral changes in real life.

To ensure that the interactive design in the game can effectively promote cognitive reconstruction and emotional regulation in patients, the investigators used the following game interaction strategies:

1. Situational simulation: By simulating real-life situations, patients face challenges and make decisions in the game that are similar to those in real life, so as to train their cognitive and emotional regulation.

2. Immediate feedback: Provide patients with immediate feedback during the game so that they can understand the impact of their decisions on the outcome of the game, thus encouraging them to make more positive decisions in real life.

3. Role-imitation: Encourage patients to take an in-depth look at their thoughts and behaviors from a third-person perspective by having them take on the role of a therapy practitioner.

Study Timeline

• Study Start: 2023-09-01
• Study First Submitted: 2023-12-08
• Study First Submitted QC: 2023-12-17
• Study First Posted: 2023-12-19
• Primary Completion: 2024-08-01
• Status Verified: 2025-07
• Last Update Submitted: 2025-07-10
• Last Update Posted: 2025-07-15
• Study Completion: 2025-09-01

Recruitment & Eligibility

• Status: SUSPENDED
• Sex: All
• Target Recruitment: 20

Inclusion Criteria

• Stable Phase Schizophrenia
• on long-term medication
• medication adherence was problematic

Exclusion Criteria

• Serious Schizophrenia
• Lack of basic cognitive abilities

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: SINGLE_GROUP

Primary Outcome Measures

Name	Time	Method
Medication Adherence	10 minutes	Medication Adherence - Morisky Medication Adherence Scale-8 (MMAS-8): This scale assesses medication adherence through 8 items, providing a comprehensive evaluation of adherence.
Medication Attitude	10 minutes	Medication Attitude - Drug Attitude Inventory (DAI) : This scale evaluates patients' attitudes toward medication, with higher scores indicating better attitudes.

Secondary Outcome Measures

Name	Time	Method
Game Experience	10 minutes	the In-Game Core Scale (iGEQ): a standardized tool used to measure a player's experience while playing a video game. It was developed by researchers to understand how players feel during gameplay, based on psychological and emotional factors.
Anxiety	10 minutes	Anxiety - Generalized Anxiety Disorder 7 (GAD-7) : This scale measures the level of anxiety in individuals, categorizing the severity into mild, moderate, and severe levels.
Depression	10 minutes	Depression - Patient Health Questionnaire-9 (PHQ-9): This scale assesses the severity of depressive symptoms, categorizing the level of depression from mild to severe.
Patients' Quality of Life	10 minutes	World Health Organization Quality of Life-BREF (WHOQOL-BREF) : This scale evaluates overall quality of life and health status, with a focus on physical, psychological, social, and environmental domains.
Social Functioning	10 minutes	Social Disability Screening Schedule (SDSS): This scale assesses the degree of social disability, with higher scores indicating more severe social dysfunction.
Clinical Symptoms	10 minutes	Clinical Symptoms - Brief Psychiatric Rating Scale (BPRS): This scale evaluates clinical symptoms across five factors, including anxiety-depression, lack of vitality, thought disturbances, activation, and hostile suspicion.

Trial Locations

Locations (1)

Shanghai Jiao Tong University; 🇨🇳 Shanghai, Shanghai, China