Who would ever think that a hugely popular virtual reality adventure video game Duke Nukem could provide crucial clues not only in diagnosing depression, but also in determining the severity of such illness? Instead of the usual series of probing questions about dreams and relationship with your family, relatives or friends, you are sent forth to fight against marauding aliens in a virtual environment.
What attracted the interest of the U.S. National Institute of Mental Health (NIMH) team of experts is the navigational tasks involve in the game more than its martial elements. Based on different studies about depression, the condition could be linked to shrinkage or dysfunction of the hippocampus, the part of the brain in charged with memory and spatial awareness.
With the use of a virtual town lifted from Duke Nukem scenes, volunteers are instructed to navigate their way to various landmarks around that town for a period of time. With the exception of the weaponry and the aliens, the NIMH team led by Leda Gould, have been able to asses spatial awareness and memory.
A distinct impairment of these mental functions was exhibited by those volunteers who are suffering from depression. This provided provided Gould and her team with a yardstick against which to measure the severity of their depression, with the most chronically depressed volunteers posting the worst results in the trial.
“Neuropsychological testing has long established the presence of memory deficits in patients with unipolar depression, and, more recently, in those suffering from bipolar depression,” wrote Gould in her article in the American Journal of Psychiatry.
“Traditionally tasks assessing spatial memory require individuals to remember the position of items in an array.
“Because of their multi-faceted nature, navigational tasks based on virtual reality may provide a more consistent, sensitive measure of spatial ability and are more likely to require hippocampal involvement, thereby increasing their sensitivity to the impact of depression on this cognitive domain.”
Other physical illnesses such as diabetes can be diagnosed and assessed with a simple test. However, there is no method yet to quantify the severity of a mental health condition like depression.
“Depression is extremely complex,” explains London-based psychoanalyst Jean Allen, “And can be very hard to diagnose and evaluate.
“It manifests itself in a variety of different ways for a variety of different people. At one end of the scale you have got those who suffer only mildly and whose lives aren’t too badly affected; at the other you have chronic clinical depression that, at its worst, can tip into full-scale psychosis.
“Measuring exactly where someone is on that continuum, or indeed if they are on it at all, is very hard.”
Although The Diagnostic and Statistical Manual of Mental Disorders have laid out categories of mental disorder, and various criteria for diagnosing and assessing those disorders, as well as numerous depression rating scales have been developed to quantify and measure the severity of mental illness, all these remain as imprecise science. They basically rely on a gradual piecing together of information through question and answer, rather than any clear cut, one-off diagnostic test.
“There are a variety of questionnaires you can use to help assess someone’s mental health condition,” says Jean Allen, “But from a psychoanalyst’s point of view they are not really very accurate.”
This is where the virtual reality navigation test comes in to fill such gap. While the study does not provide a clear-cut technique for actually diagnosing depression, it definitely offers the possibility of a new and more accurate yardstick for measuring the level of depression.