Dellazizzo Laura, Potvin Stéphane, Phraxayavong Kingsada, Dumais Alexandre
Research Center of the Institut Universitaire en Santé Mentale de Montréal, 7331 Hochelaga, Montreal, QC H1N 3V2, Canada.
Department of Psychiatry and Addictology, Faculty of Medicine, University of Montreal, Montreal, QC H3T 1J4, Canada.
J Clin Med. 2020 Sep 30;9(10):3169. doi: 10.3390/jcm9103169.
Combining cognitive behavioral therapy (CBT) for psychosis with another psychosocial intervention comprising virtual reality (VR)-assisted therapy (VRT) may improve targeted outcomes in treatment-resistant schizophrenia patients.
Ten participants having followed CBT were part of our comparative clinical trial comparing VRT to CBT and were selected at the end of the study as they desired to continue to achieve improvements with VRT (CBT + VRT). Clinical assessments were administered before/after treatments and at follow-ups. Changes in outcomes were examined using linear mixed-effects models. To gain a more in depth understanding on CBT + VRT, therapists' notes, and open interviews on a sub-group of patients were qualitatively analyzed.
Findings showed that the sequence of both interventions was appreciated by all patients. Several significant improvements were found throughout time points on auditory verbal hallucinations, beliefs about voices, depressive symptoms, symptoms of schizophrenia and quality of life. Although most of these improvements were in similar range to those observed in our comparative trial, effects of CBT + VRT on depressive symptoms and symptoms of schizophrenia were larger than those found for either intervention alone.
This proof of concept is the first to merge gold-standard CBT with VRT for treatment refractory voices and to suggest a certain synergistic effect.
将针对精神病的认知行为疗法（CBT）与另一种包含虚拟现实（VR）辅助疗法（VRT）的心理社会干预相结合，可能会改善难治性精神分裂症患者的靶向治疗效果。
10名接受过CBT治疗的参与者参与了我们将VRT与CBT进行比较的临床试验，他们在研究结束时被选中，因为他们希望继续通过VRT（CBT+VRT）实现病情改善。在治疗前/后以及随访时进行临床评估。使用线性混合效应模型检查结果的变化。为了更深入地了解CBT+VRT，对一组患者的治疗师记录和开放式访谈进行了定性分析。
研究结果表明，所有患者都认可这两种干预措施的顺序。在听觉言语幻觉、对声音的信念、抑郁症状、精神分裂症症状和生活质量的各个时间点都发现了一些显著改善。尽管这些改善大多与我们比较试验中观察到的改善范围相似，但CBT+VRT对抑郁症状和精神分裂症症状的影响大于单独使用任何一种干预措施的效果。
这一概念验证首次将金标准CBT与VRT合并用于治疗难治性幻听，并表明存在一定的协同效应。
