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虚拟现实辅助认知行为疗法治疗酒精使用障碍门诊患者(CRAVR):一项随机对照试验方案。

Virtual reality-assisted cognitive behavioural therapy for outpatients with alcohol use disorder (CRAVR): a protocol for a randomised controlled trial.

机构信息

Psychiatric Centre Copenhagen, Department of Neuroscience and Pharmacology, Capital Region of Denmark Mental Health Services, Kobenhavn, Hovedstaden, Denmark

Psychiatric Centre Copenhagen, Department of Neuroscience and Pharmacology, Capital Region of Denmark Mental Health Services, Kobenhavn, Hovedstaden, Denmark.

出版信息

BMJ Open. 2023 Mar 29;13(3):e068658. doi: 10.1136/bmjopen-2022-068658.

Abstract

INTRODUCTION

Alcohol use disorder (AUD) is a brain disorder linked to over 200 health conditions. Cognitive behavioural therapy (CBT) is considered the best practice in the treatment of AUD, but more than 60% of patients relapse within the first year after treatment. Psychotherapy combined with virtual reality (VR) has received increasing interest in the treatment of AUD. However, existing studies have primarily investigated the use of VR for cue reactivity. We therefore aimed to investigate the effect of VR-assisted CBT (VR-CBT).

METHODS AND ANALYSIS

This study is an assessor-blinded, randomised clinical trial being conducted at three outpatient clinics in Denmark. We will randomise 102 patients to 14 individual sessions of either manualised VR-CBT or CBT. The VR-CBT group will receive exposure to immersive high-risk VR situations from a pub, bar/party, restaurant, supermarket and at-home (30 videos) to activate high-risk-related beliefs and cravings for subsequent modification using CBT techniques. The treatment period is 6 months, and follow-up visits will be performed 3, 6, 9 and 12 months after inclusion. The primary outcome measure is the change in total alcohol consumption from baseline to 6 months after inclusion, measured with the Timeline Followback Method. Key secondary outcome measures include changes in the number of heavy drinking days, alcohol cravings, cognition, and symptoms of depression and anxiety.

ETHICS AND DISSEMINATION

Approval has been obtained by the research ethics committee in the Capital Region of Denmark (H-20082136) and the Danish Data Protection Agency (P-2021-217). All patients will receive both oral and written information about the trial and written informed consent will be obtained from each patient before inclusion. The study results will be disseminated in peer-reviewed publications and conference presentations.

TRIAL REGISTRATION NUMBER

ClinicalTrial.gov, NCT05042180.

摘要

简介

酒精使用障碍(AUD)是一种与 200 多种健康状况相关的脑部疾病。认知行为疗法(CBT)被认为是 AUD 治疗的最佳实践,但超过 60%的患者在治疗后一年内复发。心理治疗与虚拟现实(VR)相结合在 AUD 治疗中受到越来越多的关注。然而,现有的研究主要调查了 VR 在线索反应中的应用。因此,我们旨在研究 VR 辅助认知行为疗法(VR-CBT)的效果。

方法和分析

这是一项在丹麦三家门诊诊所进行的评估者盲法、随机临床试验。我们将随机分配 102 名患者接受 14 次个体化治疗,分别为:接受手册化 VR-CBT 或 CBT。VR-CBT 组将接受来自酒吧、酒吧/派对、餐厅、超市和家庭(30 个视频)的沉浸式高危 VR 情境暴露,以激活与高危相关的信念和对随后使用 CBT 技术进行修改的渴望。治疗期为 6 个月,在纳入后 3、6、9 和 12 个月进行随访。主要结局测量是从基线到纳入后 6 个月的总饮酒量变化,使用时间线回溯法测量。关键次要结局测量包括重度饮酒天数、酒精渴望、认知和抑郁焦虑症状的变化。

伦理和传播

丹麦首都大区研究伦理委员会(H-20082136)和丹麦数据保护局(P-2021-217)已批准该研究。所有患者将获得关于试验的口头和书面信息,并在纳入前获得每位患者的书面知情同意。研究结果将在同行评议的出版物和会议演讲中传播。

试验注册号

ClinicalTrial.gov,NCT05042180。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a89b/10069573/d67425df98c9/bmjopen-2022-068658f01.jpg

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