32 Chapter 2 et al., 2015). As opposed to pure entertainment purposes, their primary aim is to educate or motivate users, and to train or promote behaviour change (Michael & Chen, 2005; Stapleton, 2004; Stokes, 2005; Vajawat et al., 2021). The potential and promising effects of applied games for mental health have been shown in several reviews and meta-analyses focussing on multiple or broad mental health domains (Ahmed et al., 2023; David et al., 2020; Dewhirst et al., 2022; Eichenberg & Schott, 2017; Fleming et al., 2017; Halldorsson et al., 2021; Johnson et al., 2016; Lau et al., 2017; Shah et al., 2018; Townsend et al., 2022), or specific mental health conditions such as depression (Dias et al., 2018; Fleming et al., 2014; Li et al., 2014; Rasing et al., 2020), anxiety (Barnes & Prescott, 2018), ADHD (Penuelas-Calvo et al., 2020), and schizophrenia (Macedo et al., 2015). In general, these reviews and meta-analyses have shown small to moderate significant effects on improvement of symptoms, favouring applied games over no intervention or active control conditions. Applied games include both ‘gamification’ and ‘serious games’ (Fleming et al., 2017; Schmidt et al., 2015; Vajawat et al., 2021). Gamification is commonly defined as the use of gaming features in non-game contexts (Cheng, 2020; Deterding et al., 2011; Fleming et al., 2020). Game elements that are often added to interventions include the use of an objective and rules, feedback (e.g., obtaining points, rewards or achievement badges), increasing difficulty levels, competition, customizable avatars/characters and narratives (Brown et al., 2016; Cheng et al., 2019; Cugelman, 2013; Park & Bae, 2014; Seaborn & Fels, 2015). These elements, however, do not necessarily focus on playfulness and fun (Fleming et al., 2017). On the other hand, serious games are experiences that seek to leverage the structure and function of play: they are designed to be immersive and entertaining as well as incorporating evidence-based therapeutic techniques (Eichenberg & Schott, 2017; Fleming et al., 2014; Zayeni et al., 2020). Although gamification and serious games may seem easily distinguishable, various definitions exist and the terms have been used interchangeably in the literature (Cheng et al., 2019; Eichenberg & Schott, 2017; Fleming et al., 2017; Lau et al., 2017; Seaborn & Fels, 2015; Vajawat et al., 2021). Therefore, the current review did not distinguish between gamified and serious game interventions. Casual Games The effects of regular entertainment games or commercially available, off-theshelf games (herein ‘casual games’) on mental health have also been examined. These games are affordable and widely available for the general population and provide repeated training for target behaviours (Ceranoglu, 2010; Colder Carras
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