Depression screening using video games

June 17, 2026

Depression screening using video games

Depression, or major depressive disorder, is a mood disorder that causes persistent feelings of sadness and loss of interest. Despite being widespread, the mechanisms underlying depression remain unknown.

Depression symptoms may stem from how the brain determines whether things are rewarding. For example, a slice of pizza may be pleasing to someone who has no food but not pleasing to someone who is expecting a gourmet meal. The benchmark used by the brain to determine if a given event is positive or negative is called the decisional reference point. Researchers have proposed that an elevated reference point might cause someone to view once pleasurable experiences as negative.

An NIH-funded research team led by Drs. Aadith Vittala, Dan Iosifescu, and Paul Glimcher of the NYU Grossman School of Medicine set out to test this. They asked 50 people with moderate or severe depression and 70 healthy people to play two video games designed to measure a person's decisional reference point. The results were published on May 18, 2026, in the Proceedings of the National Academy of Sciences.

The first game measured when a person no longer found a task rewarding. Participants were asked to virtually collect apples from trees. Each time a tree was harvested it yielded fewer apples. The participants could then choose to stay at the same tree or move to an unharvested tree. Participants with depression moved on to harvest new trees sooner than those without it. How soon the participants with depression moved on correlated with the severity of their depression symptoms.

The participants also played a bidding video game to measure how their reference points adapted to change. First, they were asked the most they would pay for each of 30 snack items. This set their baseline decisional reference point. Then each participant was presented with either their top 10 or bottom 10 snack items, one at a time, and asked to rate their desirability over many trials. This forced them to adjust their reference point to the value of the available options. Finally, they were presented with the original list of 30 items and asked to rank them by price again. Healthy participants were able to adjust their reference points, but participants with depression could not.

The results suggest that the people with depression had elevated reference points. They also had a reduced ability to adapt their reference point to changing circumstances. The degree of reference point elevation correlated with depression severity. Video game-like tests that measure the reference point could identify people with depression. With further testing, these brief tests could potentially be used to quickly screen for and track depression in the clinic.

"Our behavioral game gives us clues to what is happening in the brains of patients with depression," Glimcher says. "We hope it will let us identify them as reliably as finding heart disease by taking someone's blood pressure."

-by Amber Snyder

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References

Decisional reference point pathology: a cognitive mechanism for and a correlate of major depressive disorder in humans.(link is external) Vittala A, Wu L, Yan D, Liebers D, Tell E, Song X, Dashti D, Louie K, Raio C, Iosifescu DV, Glimcher PW. Proc Natl Acad Sci U S A. 2026 May 26;123(21):e2518826123. doi: 10.1073/pnas.2518826123. Epub 2026 May 18. PMID: 42150067.

Funding

NIH's National Institute of Mental Health (NIMH).