Kothgassner Oswald D, Goreis Andreas, Kafka Johanna X, Van Eickels Rahel L, Plener Paul L, Felnhofer Anna
Department of Child and Adolescent Psychiatry, Medical University of Vienna, Wien, Austria.
Department of Applied Psychology: Health, Development, Enhancement and Intervention, Faculty of Psychology, University of Vienna, Wien, Austria.
Eur J Psychotraumatol. 2019 Aug 19;10(1):1654782. doi: 10.1080/20008198.2019.1654782. eCollection 2019.
Contrary to specific phobias, for which Virtual Reality Exposure Therapy (VRET) constitutes an effective treatment, uncertainty still exists regarding the usefulness of VRET for posttraumatic stress disorder (PTSD). Therefore, this meta-analysis investigated the efficacy of VRET for PTSD as compared to waitlist and active comparators. A literature search yielded nine controlled studies encompassing 296 participants (124 VRET, 172 controls). The differences between conditions regarding the primary outcome of PTSD symptom severity and the secondary outcome of depressive and anxiety symptoms post-treatment were calculated using Hedges' . Compared to waitlist controls, VRET showed a significantly better outcome for PTSD symptoms ( = 0.62, = .017) and depressive symptoms ( = 0.50, = .008). There was no significant difference between VRET and active comparators regarding PTSD symptoms ( = 0.25, = .356) and depressive symptoms ( = 0.24, = .340) post-treatment. No significant effects emerged for anxiety symptoms. These findings suggest that VRET may be as effective as active comparators for PTSD patients. However, the results must be interpreted with caution due to the limited number of trials and the substantial number of - predominantly male - military service members studied. Additional controlled trials, considering a wider range of trauma types and balanced gender, are required to strengthen the evidence.
与虚拟现实暴露疗法（VRET）对特定恐惧症构成有效治疗方法不同，VRET对创伤后应激障碍（PTSD）的有效性仍存在不确定性。因此，本荟萃分析调查了VRET与等待名单及积极对照相比对PTSD的疗效。文献检索得到9项对照研究，涉及296名参与者（124名接受VRET，172名作为对照）。使用赫奇斯效应量计算治疗后PTSD症状严重程度这一主要结果以及抑郁和焦虑症状这一次要结果在不同条件之间的差异。与等待名单对照相比，VRET在PTSD症状（效应量=0.62，P=0.017）和抑郁症状（效应量=0.50，P=0.008）方面显示出明显更好的结果。治疗后，VRET与积极对照在PTSD症状（效应量=0.25，P=0.356）和抑郁症状（效应量=0.24，P=0.340）方面没有显著差异。焦虑症状方面未出现显著效果。这些发现表明，VRET对PTSD患者可能与积极对照一样有效。然而，由于试验数量有限以及所研究的主要为男性的大量军人，结果必须谨慎解读。需要更多对照试验，考虑更广泛的创伤类型并实现性别平衡，以加强证据。
