Centre de recherche de l'Institut Universitaire en Santé Mentale de Montréal, Montreal, Canada; Department of Psychiatry, Faculty of Medicine, University of Montreal, Montreal, Canada; Institut Philippe-Pinel de Montréal, Montreal, Canada.
Centre de recherche de l'Institut Universitaire en Santé Mentale de Montréal, Montreal, Canada; Department of Psychiatry, Faculty of Medicine, University of Montreal, Montreal, Canada.
Schizophr Res. 2018 Jul;197:176-181. doi: 10.1016/j.schres.2018.02.031. Epub 2018 Feb 24.
Schizophrenia is a chronic and severe mental illness that poses significant challenges. While many pharmacological and psychosocial interventions are available, many treatment-resistant schizophrenia patients continue to suffer from persistent psychotic symptoms, notably auditory verbal hallucinations (AVH), which are highly disabling. This unmet clinical need requires new innovative treatment options. Recently, a psychological therapy using computerized technology has shown large therapeutic effects on AVH severity by enabling patients to engage in a dialogue with a computerized representation of their voices. These very promising results have been extended by our team using immersive virtual reality (VR). Our study was a 7-week phase-II, randomized, partial cross-over trial. Nineteen schizophrenia patients with refractory AVH were recruited and randomly allocated to either VR-assisted therapy (VRT) or treatment-as-usual (TAU). The group allocated to TAU consisted of antipsychotic treatment and usual meetings with clinicians. The TAU group then received a delayed 7weeks of VRT. A follow-up was ensured 3months after the last VRT therapy session. Changes in psychiatric symptoms, before and after TAU or VRT, were assessed using a linear mixed-effects model. Our findings showed that VRT produced significant improvements in AVH severity, depressive symptoms and quality of life that lasted at the 3-month follow-up period. Consistent with previous research, our results suggest that VRT might be efficacious in reducing AVH related distress. The therapeutic effects of VRT on the distress associated with the voices were particularly prominent (d=1.2). VRT is a highly novel and promising intervention for refractory AVH in schizophrenia.
精神分裂症是一种慢性且严重的精神疾病，给患者带来了巨大的挑战。虽然有许多药理学和心理社会干预措施可用，但许多治疗抵抗的精神分裂症患者仍然持续遭受持续的精神病症状，尤其是听觉言语幻觉（AVH），这对患者的功能损伤极大。这种未满足的临床需求需要新的创新治疗选择。最近，一种使用计算机技术的心理治疗方法通过使患者能够与他们的声音的计算机化表示进行对话，显示出对 AVH 严重程度的较大治疗效果。我们的团队通过沉浸式虚拟现实（VR）扩展了这些非常有前途的结果。我们的研究是一项为期 7 周的 II 期、随机、部分交叉试验。招募了 19 名难治性 AVH 的精神分裂症患者，并随机分配到虚拟现实辅助治疗（VRT）或常规治疗（TAU）组。分配到 TAU 组的患者接受抗精神病药物治疗和与临床医生的常规会面。然后，TAU 组接受了延迟的 7 周 VRT。确保在最后一次 VRT 治疗后 3 个月进行随访。使用线性混合效应模型评估 TAU 或 VRT 前后精神病症状的变化。我们的研究结果表明，VRT 可显著改善 AVH 严重程度、抑郁症状和生活质量，并且在 3 个月的随访期内持续有效。与先前的研究一致，我们的结果表明 VRT 可能对减轻与 AVH 相关的痛苦有效。VRT 对与声音相关的痛苦的治疗效果特别明显（d=1.2）。VRT 是一种治疗精神分裂症难治性 AVH 的高度新颖且有前途的干预措施。
