Lohse Luzie, Rolvien Lara, Borsutzky Swantje, Kühn Simone, Miegel Franziska, Jelinek Lena
Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany.
Lise Meitner Group for Environmental Neuroscience, Max Planck Institute for Human Development, Lentzeallee 94, 14195, Berlin, Germany.
Neuropsychiatr. 2025 Jun;39(2):55-67. doi: 10.1007/s40211-025-00518-6. Epub 2025 Mar 21.
Exposure and response prevention therapy in virtual reality (VERP) for patients with obsessive-compulsive disorder (OCD) has been investigated primarily for its effectiveness. This study evaluated an important research gap, the negative and positive side effects of VERP and its safety. Eighty outpatients with contamination- or checking-related OCD were randomized to two conditions: VERP (six weekly sessions) or care as usual (CAU). Assessments were conducted at baseline (t0), 6 weeks after t0 (t1), and 3 months after t1 (t2). General side effects (Negative and Positive Side Effects Questionnaire; NPSE) and those specific to virtual reality (VERP-Specific Side Effects Questionnaire; VEQ) were assessed at t1. Cybersickness (Simulator Sickness Questionnaire; SSQ) was assessed before and after each session. The safety evaluation involved assessing the worsening of OC-symptoms (Reliable Change Index of the Yale-Brown Obsessive-Compulsive Scale; Y‑BOCS) from t0 to t1 and serious adverse events during the intervention. Results indicated no significant clinical symptom deterioration in the VERP group and no adverse events. In total, 47% of participants in both groups experienced at least one side effect, with significantly fewer reported in the VERP than in the CAU group (p < 0.001). Concerning VERP-specific side effects, at least one side effect was found in 55% of the patients. The SSQ total score did not significantly change from before to after the VERP sessions (p = 0.098, Cohen's d = 0.297). In conclusion, VERP was safe and demonstrated few side effects, highlighting its potential as a well-tolerated and safe intervention for patients with OCD.
针对强迫症（OCD）患者的虚拟现实暴露与反应预防疗法（VERP）主要围绕其有效性展开了研究。本研究评估了一个重要的研究空白，即VERP的负面和正面副作用及其安全性。80名患有污染或检查相关强迫症的门诊患者被随机分为两组：VERP组（每周六次治疗）或常规护理组（CAU）。在基线期（t0）、t0后6周（t1）和t1后3个月（t2）进行评估。在t1时评估一般副作用（负面和正面副作用问卷；NPSE）以及虚拟现实特有的副作用（VERP特定副作用问卷；VEQ）。每次治疗前后评估晕动病（模拟器晕动病问卷；SSQ）。安全性评估包括评估从t0到t1时强迫症状的恶化情况（耶鲁-布朗强迫症量表可靠变化指数；Y-BOCS）以及干预期间的严重不良事件。结果表明，VERP组临床症状无显著恶化，也无不良事件发生。总体而言，两组中47%的参与者至少经历了一种副作用，VERP组报告的副作用明显少于CAU组（p < 0.001）。关于VERP特定的副作用，55%的患者至少出现了一种副作用。VERP治疗前后SSQ总分无显著变化（p = 0.098，科恩d值 = 0.297）。总之，VERP是安全的，副作用较少，凸显了其作为一种对强迫症患者耐受性良好且安全的干预措施的潜力。
