Virtual reality-assisted therapy shows promise in refractory schizophrenia

In patients with treatment-resistant schizophrenia, virtual reality-assisted therapy (VRT) is as effective as cognitive behavioural therapy (CBT), with effects lasting over time, a study reports. However, VRT confers greater benefits for auditory verbal hallucinations (AVH) and additional effects on affective symptoms and quality of life.

The study included randomized 74 patients (mean age, 42.5 years; 76 percent male) to undergo VRT (n=37) or CBT (n=37). Most patients had schizophrenia (77 percent), with a mean duration of illness of 16 years, and received atypical antipsychotics (96 percent); the other 23 percent had schizoaffective disorder. More than half of the patients were also prescribed clozapine, although they continued to experience persistent AVHs, thereby meeting the criteria for ultra-resistance.

Patients in the VRT group underwent nine weekly sessions comprising one avatar creation session and eight therapeutic sessions where patients were immersed into the VR setting. Those in the CBT group, on the other hand, attended nine weekly 1-hour sessions administered in an individual format, with the intervention involving a succession of learning modules and suggested task assignments.

Three-month findings showed that both interventions were effective in terms of reducing AVH severity and depressive symptoms. Although AVH improvements achieved with VRT were not superior over those obtained with CBT, the former did yield larger effects. Meanwhile, there were significant between-group differences in affective symptoms, in favour of VRT. It also produced significant effects on persecutory beliefs and quality of life.

Notably, the effects were maintained up to the first year of follow-up.

The present data underscore the potential of VRT for voices. A fully powered single-blind randomized controlled trial comparing VRT to CBT is ongoing.