One-year randomized trial comparing virtual reality-assisted therapy to cognitive–behavioral therapy for patients with treatment-resistant schizophrenia

Abstract

The gold-standard cognitive–behavioral therapy (CBT) for psychosis offers at best modest effects. With advances in technology, virtual reality (VR) therapies for auditory verbal hallucinations (AVH), such as AVATAR therapy (AT) and VR-assisted therapy (VRT), are amid a new wave of relational approaches that may heighten effects. Prior trials have shown greater effects of these therapies on AVH up to a 24-week follow-up. However, no trial has compared them to a recommended active treatment with a 1-year follow-up. We performed a pilot randomized comparative trial evaluating the short- and long-term efficacy of VRT over CBT for patients with treatment-resistant schizophrenia. Patients were randomized to VRT (n = 37) or CBT (n = 37). Clinical assessments were administered before and after each intervention and at follow-up periods up to 12 months. Between and within-group changes in psychiatric symptoms were assessed using linear mixed-effects models. Short-term findings showed that both interventions produced significant improvements in AVH severity and depressive symptoms. Although results did not show a statistically significant superiority of VRT over CBT for AVH, VRT did achieve larger effects particularly on overall AVH (d = 1.080 for VRT and d = 0.555 for CBT). Furthermore, results suggested a superiority of VRT over CBT on affective symptoms. VRT also showed significant results on persecutory beliefs and quality of life. Effects were maintained up to the 1-year follow-up. VRT highlights the future of patient-tailored approaches that may show benefits over generic CBT for voices. A fully powered single-blind randomized controlled trial comparing VRT to CBT is underway.

Feasibility and Efficacy of Virtual Reality Interventions to Improve Psychosocial Functioning in Psychosis: Systematic Review

“…Disagreements were resolved through discussion until a consensus was reached. Multimedia Appendix 1 [40,[42][43][44][45][46][47][48][49][50][51][52][53][54][55][56][57][58][59][60][61] provides more information on each tool used to assess the risk of bias in the included studies.…”

“…Table 1 provides a general summary of the included studies. Table S1 in Multimedia Appendix 2 [44][45][46][47][48][49][50][51][52][53][54][55][56][57][58][59][60][61] provides further details of the studies included in this systematic review.…”

“…Within the auditory verbal hallucinations or paranoia category, 3 studies used the same intervention in which participants created avatars that most accurately resembled the entity they believed was the source of their hallucinations [55][56][57]. Participants then engaged in a dialogue with these avatars, which were animated in real time by a therapist.…”

“…Participants who had already undergone CBT m as part of the study by Dellazizzo et al [56] were invited to complete the VR intervention (ie, after finishing CBT). The VR intervention was identical to that used in Dellazizzo et al [56], which is described further in the table.…”

Inibidores Sglt2 E Insuficiência Cardíaca: Atualizações

“…De acordo com Pétré et alquando a temática é a terapêutica. Um exemplo a ser seguido é a nova terapia cognitivocomportamental (TCC), que apresenta qualidade na área de tratamento para a psicose em pacientes com esquizofrenia, permitindo um mecanismo de identificação para a origem das alucinações por intermédio da realidade virtual(DELLAZIZZO et al, 2021). que essas patologias estão associadas a presença de mutações, tornando-se resistentes aos tratamentos básicos, os quais focam na quantidade de glicose no organismo, não atentando-se para as causas genéticas e moleculares que geraram a doença (PRASAD, R.B.…”