Figure - available from: Journal of Eating Disorders
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Background
Co-production is increasingly used in mental health research and clinical settings. Maze Out is a digital game co-produced by clinicians, patients with eating disorders (EDs), an art director with lived experience in EDs, and a game-developing company. Maze Out is based on everyday challenges when suffering from EDs and is currently bein...
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Citations
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).
