Virtual Reality for Patients With Schizophrenia

VR-based training may help improve social cognition and functioning in patients with schizophrenia.

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Virtual reality (VR) technology could be effective in treating patients with schizophrenia who suffer from motivational deficits and low treatment adherence. According to the preliminary findings of a recent study, VR-based social cognition and interaction training (VR-SCIT) is a promising method for improving social cognition and functioning in patients with schizophrenia.

Researchers developed a novel VR-SCIT that combined traditional SCIT (TR-SCIT) intervention with VR technology, and compared its efficacy with that of traditional SCIT.

“VR is immersive, interactive, and dynamic, and it elicits psychological reactions that are similar to those occurring in everyday life. Therefore, it is suitable for simulating a range of social situations and accurately portraying their complexity,” wrote the study authors.1

Researchers separated 87 participants diagnosed with schizophrenia into either a VR-SCIT group or a TR-SCIT group. Findings showed that VR-SCIT had a higher treatment adherence than TR-SCIT, which may be partially explained by its gamification-oriented design,2,3 and a comparable efficacy. Both the VR-SCIT and TR-SCIT groups demonstrated statistically significant improvements in the domains of emotion perception, metacognition, hostile attributional bias, and social functioning from baseline. Additionally, VR-SCIT showed an advantage over TR-SCIT in improving emotion perception and metacognition with higher treatment compliance; this may be associated with the more intense and immersive training in VR-SCIT than in TR-SCIT.

Virtual reality interventions have seen prior success in other settings aimed at evaluating and improving symptoms and functional outcomes in schizophrenia.4-8 This research indicates VR may be useful as a stand-alone or adjunct treatment for patients with schizophrenia and other psychotic diseases.9,10

“The present study provides the first evidence that VR-SCIT has the potential to improve social cognition in patients with schizophrenia,” said the authors.1 “Although preliminary, it is suggested that the SCIT program, including the VR-based format, should become part of routine clinical interventions for patients with schizophrenia.”

References

1. Shen ZH, Liu MH, Wu Y, et al. Virtual-reality-based social cognition and interaction training for patients with schizophrenia: a preliminary efficacy study. Front Psychiatry. 2022;13:1022278.

2. Sardi L, Idri A, Fernández-Alemán JL. A systematic review of gamification in e-Health. J Biomed Inform. 2017;71:31-48.

3. Vajawat B, Varshney P, Banerjee D. Digital gaming interventions in psychiatry: evidence, applications and challenges. Psychiatry Res. 2021;295:113585.

4. Rus-Calafell M, Garety P, Sason E, et al. Virtual reality in the assessment and treatment of psychosis: a systematic review of its utility, acceptability and effectiveness. Psychol Med. 2018;48(3):362-391.

5. Park KM, Ku J, Choi SH, et al. A virtual reality application in role-plays of social skills training for schizophrenia: a randomized, controlled trial. Psychiatry Res. 2011;189(2):166-172.

6. Pot-Kolder RMCA, Geraets CNW, Veling W, et al. Virtual-reality-based cognitive behavioural therapy versus waiting list control for paranoid ideation and social avoidance in patients with psychotic disorders: a single-blind randomised controlled trial. Lancet Psychiatry. 2018;5(3):217-226.

7. Horan B, Heckenberg R, Maruff P, Wright B. Development of a new virtual reality test of cognition: assessing the test-retest reliability, convergent and ecological validity of CONVIRT. BMC Psychol. 2020;8(1):61.

8. Nijman SA, Veling W, Greaves-Lord K, et al. Dynamic interactive social cognition training in virtual reality (DiSCoVR) for people with a psychotic disorder: single-group feasibility and acceptability study. JMIR Ment Health. 2020;7(8):e17808.

9. Adery LH, Ichinose M, Torregrossa LJ, et al. The acceptability and feasibility of a novel virtual reality based social skills training game for schizophrenia: preliminary findings. Psychiatry Res. 2018;270:496-502.

10. Freeman D, Reeve S, Robinson A, et al. Virtual reality in the assessment, understanding, and treatment of mental health disorders. Psychol Med. 2017;47:2393-2400.

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