Schroeder Alexandra H, Bogie Bryce J M, Rahman Tabassum T, Thérond Alexandra, Matheson Hannah, Guimond Synthia
The Royal's Institute of Mental Health Research, University of Ottawa, Ottawa, ON, Canada.
Department of Neuroscience, Carleton University, Ottawa, ON, Canada.
JMIR Ment Health. 2022 Feb 18;9(2):e28502. doi: 10.2196/28502.
Functional recovery in psychosis remains a challenge despite current evidence-based treatment approaches. To address this problem, innovative interventions using virtual reality (VR) have recently been developed. VR technologies have enabled the development of realistic environments in which individuals with psychosis can receive psychosocial treatment interventions in more ecological settings than traditional clinics. These interventions may therefore increase the transfer of learned psychosocial skills to real-world environments, thereby promoting long-term functional recovery. However, the overall feasibility and efficacy of such interventions within the psychosis population remain unclear.
This systematic review aims to investigate whether VR-based psychosocial interventions are feasible and enjoyable for individuals with psychosis, synthesize current evidence on the efficacy of VR-based psychosocial interventions for psychosis, and identify the limitations in the current literature to guide future research.
This research followed the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Literature searches were conducted in PubMed and PsycINFO in May 2021. We searched for peer-reviewed English articles that used a psychosocial intervention with a VR component. Participants in the included studies were diagnosed with schizophrenia, schizoaffective disorder, or another psychotic disorder. The included studies were divided into four categories as follows: cognitive remediation interventions, social skills interventions, vocational skills interventions, and auditory verbal hallucinations and paranoia interventions. The risk of bias assessment was performed for each study.
A total of 18 studies were included in this systematic review. Of these 18 studies, 4 (22%) studies used a cognitive remediation intervention, 4 (22%) studies used a social skills intervention, 3 (17%) studies used a vocational skills intervention, and 7 (39%) studies implemented an intervention aimed at improving auditory verbal hallucinations or paranoia. A total of 745 individuals with psychosis were included in the study. All the studies that evaluated feasibility showed that VR-based psychosocial interventions were feasible and enjoyable for individuals with psychosis. The preliminary evidence on efficacy included in this review suggests that VR-based psychosocial interventions can improve cognitive, social, and vocational skills in individuals with psychosis. VR-based interventions may also improve the symptoms of auditory verbal hallucinations and paranoia. The skills that participants learned through these interventions were durable, transferred into real-world environments, and led to improved functional outcomes, such as autonomy, managing housework, and work performance.
VR-based interventions may represent a novel and efficacious approach for improving psychosocial functioning in psychosis. Therefore, VR-based psychosocial interventions represent a promising adjunctive therapy for the treatment of psychosis, which may be used to improve psychosocial skills, community functioning, and quality of life.
尽管目前有循证治疗方法，但精神病的功能恢复仍然是一项挑战。为解决这一问题，最近开发了使用虚拟现实（VR）的创新干预措施。VR技术使逼真环境的开发成为可能，在这种环境中，精神病患者可以在比传统诊所更贴近现实生活的场景中接受心理社会治疗干预。因此，这些干预措施可能会增加所学心理社会技能向现实世界环境的转化，从而促进长期功能恢复。然而，这类干预措施在精神病患者群体中的总体可行性和疗效仍不明确。
本系统评价旨在调查基于VR的心理社会干预措施对精神病患者是否可行且令人满意，综合当前关于基于VR的心理社会干预措施治疗精神病疗效的证据，并确定当前文献中的局限性以指导未来研究。
本研究遵循PRISMA（系统评价和Meta分析的首选报告项目）指南。2021年5月在PubMed和PsycINFO中进行文献检索。我们搜索了使用含VR成分的心理社会干预措施的同行评审英文文章。纳入研究的参与者被诊断患有精神分裂症、分裂情感性障碍或其他精神病性障碍。纳入研究分为以下四类：认知康复干预、社交技能干预、职业技能干预以及幻听和偏执干预。对每项研究进行偏倚风险评估。
本系统评价共纳入18项研究。在这18项研究中，4项（22%）研究使用了认知康复干预，4项（22%）研究使用了社交技能干预，3项（17%）研究使用了职业技能干预，7项（39%）研究实施了旨在改善幻听或偏执的干预。该研究共纳入745名精神病患者。所有评估可行性的研究均表明，基于VR的心理社会干预措施对精神病患者可行且令人满意。本评价纳入的关于疗效的初步证据表明，基于VR的心理社会干预措施可改善精神病患者的认知、社交和职业技能。基于VR的干预措施也可能改善幻听和偏执症状。参与者通过这些干预措施学到的技能具有持久性，能转化到现实世界环境中，并带来功能结局的改善，如自主性、家务管理和工作表现。
基于VR的干预措施可能是改善精神病患者心理社会功能的一种新颖且有效的方法。因此，基于VR的心理社会干预措施是一种有前景的精神病辅助治疗方法，可用于提高心理社会技能、社区功能和生活质量。
