Virtual Reality Therapy for the Negative Symptoms of Schizophrenia (V-NeST): A pilot randomised feasibility trial

Cella, Matteo; Tomlin, Paul; Robotham, Daniel; Green, Patrick; Griffiths, Helena; Ståhl, Daniel; Valmaggia, Lucia

doi:10.1016/j.schres.2022.07.013

Cited by 10 publications

(14 citation statements)

References 38 publications

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“…84 Intervention development may also take advantage of digital technology tools that may facilitate or complement the delivery of interventions; with a recent example of this being a virtual-reality-supported psychological-targeted intervention for negative symptoms. 85 Optimally intervention trials should be well defined in terms of their model of intervention, mechanics dosage, comparison conditions and provide information on the long-term benefits and cost-benefit. The results of the current study map the state of the evidence and indicate some interventions approach with the potential to be further developed, evaluated and used routinely in clinical practice.…”

Section: Discussionmentioning

confidence: 99%

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Psychosocial and behavioural interventions for the negative symptoms of schizophrenia: a systematic review of efficacy meta-analyses

et al. 2023

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Background Currently there is no first-line treatment recommended for the negative symptoms of schizophrenia. Psychosocial and behavioural interventions are widely used to reduce the burden of negative symptoms. Meta-analytic studies have summarised the evidence for specific approaches but not compared evidence quality and benefit. Aim To review and evaluate the evidence from meta-analytic studies of psychosocial and behavioural interventions for the negative symptoms of schizophrenia. Method A systematic literature search was undertaken to identify all meta-analyses evaluating psychosocial and behavioural interventions reporting on negative symptom outcomes in people with schizophrenia. Data on intervention, study characteristics, acceptability and outcome were extracted. Risk of bias was evaluated. Results were summarised descriptively, and evidence ranked on methodological quality. Results In total, 31 systematic reviews met the inclusion criteria evaluating the efficacy of negative symptom interventions on 33 141 participants. Exercise interventions showed effect sizes (reduction in negative symptoms) ranging from −0.59 to −0.24 and psychological interventions ranging from −0.65 to −0.04. Attrition ranged between 12% to 32%. Across the studies considered heterogeneity varied substantially (range 0–100). Most of the reviews were of very low to low methodological quality. Methodological quality ranking suggested that the effect size for cognitive remediation and exercise therapy may be more robust compared with other approaches. Conclusions Most of the interventions considered had a small-to-moderate effect size, good acceptability levels but very few had negative symptoms as the primary intervention target. To improve the confidence of these effect sizes being replicated in clinical settings future studies should minimise risk of bias.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Psychosocial and behavioural interventions for the negative symptoms of schizophrenia: a systematic review of efficacy meta-analyses

et al. 2023

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“…Interviews were semi-structured and adapted from schedules for evaluating technology-based intervention acceptability in people with psychosis (Cella et al, 2022). There were 18 questions for participants, and 25 questions for research therapists (see appendices A and B in the Supplementary material for interview schedules).…”

Section: Feedback Interviewsmentioning

confidence: 99%

Evaluating the acceptability of remote cognitive remediation from the perspective of psychosis service users

Parri,

Barret,

Hill

et al. 2024

Behav. Cogn. Psychother.

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Objectives: Cognitive remediation (CR) can reduce the cognitive difficulties experienced by people with psychosis. Adapting CR to be delivered remotely provides new opportunities for extending its use. However, doing so requires further evaluation of its acceptability from service users’ views. We evaluate the acceptability of therapist-supported remote CR from the perspectives of service users using participatory service user-centred methods. Method: After receiving 12 weeks of therapist-supported remote CR, service users were interviewed by a service user researcher following a semi-structured 18-question interview guide. Transcripts were analysed using reflexive thematic analysis with themes and codes further validated by a Lived Experience Advisory Panel and member checking. Results: The study recruited 26 participants, almost all of whom reported high acceptability of remote CR, and some suggested improvements. Four themes emerged: (1) perceived treatment benefits, (2) remote versus in-person therapy, (3) the therapist’s role, and (4) how it could be better. Conclusions: This study used comprehensive service user involvement methods. For some participants, technology use remained a challenge and addressing these difficulties detracted from the therapy experience. These outcomes align with existing research on remote therapy, suggesting that remote CR can expand choice and improve access to treatment for psychosis service users once barriers are addressed. Future use of remote CR should consider technology training and equipment provision to facilitate therapy for service users and therapists.

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“…One study utilized VR social training (23), two VR cognitive training (24,31), five VR-CBT-based intervention methods (11,25,26,30,32), three avatar therapy (27,29,33), and one relaxation training (28).…”

Section: Virtual Reality Interventionsmentioning

confidence: 99%

Efficacy of immersive extended reality (XR) interventions on different symptom domains of schizophrenia spectrum disorders. A systematic review

Holopainen,

Tiihonen,

Lähteenvuo

2023

Front. Psychiatry

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IntroductionExtended reality (XR) is an umbrella term for virtual reality (VR) and augmented reality (AR), both novel vectors for therapeutic intervention modalities. In VR, head-mounted devices (HMD) allow interaction with three-dimensional virtual environments and simulated avatars, while AR overlaps virtual, simulated objects to observe physical reality. Treatment through immersive VR has been studied in psychiatry, including patients suffering from schizophrenia spectrum disorders, while there has not been much attention to AR technologies in psychiatry. Our systematic review aimed to examine the currently available literature regarding the treatment efficacy of immersive VR or AR technologies on different symptom domains of schizophrenia spectrum disorders, screen for potential adverse effects, and gather data on the technological and human resource requirements of such interventions to help guide future research.MethodsWe conducted a systematic literature review with database searches carried out between 9/2021 and 8/2022 through PubMed, Scopus, EBSCOhost Academic Search Premier, and Web of Science.ResultsWe identified 2,157 records, 214 were assessed further for eligibility and 12 met inclusion criteria. All included articles studied immersive VR and none used AR technology. Included studies were heterogenous in nature, including AVATAR therapy (3) and CBT-based (5) VR interventions, as well as cognitive (2), social (1), and relaxation (1) training through VR. The comparison groups were either passive controls (waitlist and treatment as usual), therapeutic interventions (CBT and Integrated psychological treatment), passive VR environments, or traditional, comparable, non-virtual treatment modalities (social roleplay and progressive muscle relaxation training). Pooled together, the included studies on VR show positive treatment effects in all major symptom domains of schizophrenia spectrum disorders with hardly any adverse effects related to the intervention modalities.ConclusionsIn this review, we have showcased how different symptom domains can be targeted through VR interventions, highlighting VR as a potential new vector for a diverse range of psychosocial therapeutic modalities that allow for completely new possibilities in the treatment of schizophrenia spectrum disorders. VR technology still requires more research and validation. Our review also shows that there are currently no studies examining AR technology in the treatment of schizophrenia spectrum disorders, indicating a distinctive research gap.

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Virtual Reality Therapy for the Negative Symptoms of Schizophrenia (V-NeST): A pilot randomised feasibility trial

Cited by 10 publications

References 38 publications

Psychosocial and behavioural interventions for the negative symptoms of schizophrenia: a systematic review of efficacy meta-analyses

Psychosocial and behavioural interventions for the negative symptoms of schizophrenia: a systematic review of efficacy meta-analyses

Evaluating the acceptability of remote cognitive remediation from the perspective of psychosis service users

Efficacy of immersive extended reality (XR) interventions on different symptom domains of schizophrenia spectrum disorders. A systematic review

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