Mental health and digital games: A comprehensive qualitative review

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The study sample is the global commercial off-the-shelf (COTS) digital games until 2020 (from now designated by global COTS digital games), retrieved from Ribeiro & Veloso (2022). The sample of global COTS digital games includes the most sold and the most acclaimed games in the world until 2020. The global COTS digital games most sold were retrieved from the Entertainment Software Association (ESA) between 2008 and 2018 (ESA, 2009, 2010, 2011, 2012, 2013, 2014, 2015, 2016, 2017, 2018, 2019). The most sold global COTS digital games sample ended in 2018 when ESA reports stopped reporting the top-selling by its associates. To complement the sample, the most acclaimed global COTS digital games were achieved by combining several relevant sources: (i) expert consultants in digital games – Eurogamer (Welsh, 2020), IGN (GamesRadar, 2019), and Polygon (West, 2021); (ii) generalist news – the British newspaper “The Guardian” (Stuart & MacDonald, 2019) and the American magazine “Time” (Fitzpatrick et al., 2016); and (iii) a specialized website in entertainment evaluation – Metacritic (Metacritic, 2020). The global COTS digital games in the sample (N=394) include digital games developed over an extended range of years. The oldest digital game in the sample is from 1972, “Pong”, developed and published by Atari, and the most recent is from 2020, “Kentucky Route Zero”, developed by Cardboard Computer and published by Annapurna Interactive. This qualitative review gathers data from expert consultants (a game designer and a clinical psychologist), scientific evidence, and players' opinions. The expert consultant categorization (P1) included the suggestion or representation of any mental health disorder (A), followed by the categorization of the mental disorder dimension according to DSM-V (APA, 2013): neurodevelopmental disorders (A1); schizophrenia spectrum and other psychotic disorders (A2); bipolar disorder and other related disorders (A3); depressive disorders (A4); anxiety disorders (A5); obsessive-compulsive disorders and related disorders (A6); post-traumatic stress and other stress-related disorders (A7); dissociative disorders (A8); somatic symptoms disorders and other related disorders (A9); eating disorders (A10); elimination disorders (A11); sleep-wake disorders (A12); sexual disorders (A13); gender dysphoria (A14); disruptive, impulse control and conduct disorders (A15); substance-related and addictive disorders (A16); neurocognitive disorders (A17); personality disorders (A18); paraphilic disorders (A19); and other mental disorders, undefined dimension, general mental health or well-being (A20). The documental analysis (P2) included mental health-related content (B) regarding the global COTS digital games in the sample. The documental data is categorized regarding the following: (C) player's opinion – negative (C1), neutral (C2), and positive (C3); (D) scientific evidence – negative (D1), neutral (D2), and positive (D3); and (E) the main subject of the data (keywords)

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