虚拟现实暴露疗法治疗成人牙科恐惧症的疗效：一项随机对照试验。

Efficacy of virtual reality exposure therapy for the treatment of dental phobia in adults: A randomized controlled trial.

机构信息

Faculty of Dentistry, SEGi University, Petaling Jaya, Selangor, Malaysia; Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, the Netherlands.

Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, the Netherlands.

出版信息

J Anxiety Disord. 2019 Mar;62:100-108. doi: 10.1016/j.janxdis.2018.12.001.

DOI:10.1016/j.janxdis.2018.12.001

PMID:30717830

Abstract

BACKGROUND

Although Virtual Reality Exposure Therapy (VRET) has proven to be effective in the treatment of various subtypes of specific phobia, there is limited evidence of its role in the treatment of dental phobia.

METHOD

A single-blind RCT was conducted among 30 randomized patients with dental phobia to either VRET or informational pamphlet (IP) condition. Primary outcome anxiety measures (VAS-A, MDAS and DFS) were evaluated at baseline, pre- and post-intervention, 1-week, 3-months and 6-months follow-up. Secondary outcome measures assessed were pre-post behavioral avoidance, temporal variations of heart rate and VR-experience during and post-VRET, and dental treatment acceptance in both conditions at 6-month follow-up.

RESULTS

Intention to treat analysis, using a repeated measures MANOVA, revealed a multivariate interaction effect between time and condition (p = 0.015) for all primary outcome measures (all ps < 0.001). Only patients of the VRET condition showed a significant reduction in anxiety scores (mean reduction [s.d.]: VAS-A 44.4 [36.1]; MDAS 7.1 [5.4]; DFS 21.2 [13.1]) whereas the patients in the IP group did not (mean reduction [s.d.]: VAS-A -0.33 [7.7]; MDAS -0.33 [1.3]; DFS -1.9 [3.8]), F (15, 14) = 3.3, p = 0.015.

CONCLUSIONS

VRET was found to be efficacious in the treatment of dental phobia.

摘要

背景

虚拟现实暴露疗法（VRET）已被证明对各种特定恐惧症亚类的治疗有效，但在治疗牙科恐惧症方面的作用证据有限。

方法

对 30 名随机分配到 VRET 或信息手册（IP）条件的牙科恐惧症患者进行了单盲 RCT。在基线、干预前、干预后 1 周、3 个月和 6 个月随访时评估主要结局焦虑测量（VAS-A、MDAS 和 DFS）。评估的次要结局措施包括在 6 个月随访时的行为回避、心率的时间变化以及 VRET 期间和之后的 VR 体验，以及两种条件下的牙科治疗接受度。

结果

使用重复测量 MANOVA 的意向治疗分析显示，所有主要结局测量（所有 p 值均<0.001）的时间和条件之间存在多变量交互效应（p=0.015）。只有 VRET 条件的患者焦虑评分显著降低（平均降低[标准差]：VAS-A 44.4[36.1]；MDAS 7.1[5.4]；DFS 21.2[13.1]），而 IP 组的患者没有（平均降低[标准差]：VAS-A -0.33[7.7]；MDAS -0.33[1.3]；DFS -1.9[3.8]），F（15, 14）=3.3，p=0.015。