Jeon EunJin, Li Ling, Le Thi-Hung, Kim Woo-Sung, Odkhuu Soyolsaikhan, Kang Chae Yeong, Setiani Ariana, Rami Fatima Zahra, Chung Young-Chul
Department of Psychiatry, Jeonbuk National University Medical School, Jeonju, Republic of Korea.
Research Institute of Clinical Medicine, Jeonbuk National University-Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju, Republic of Korea.
Psychol Med. 2025 Apr 28;55:e121. doi: 10.1017/S0033291725000959.
No studies have investigated the effects of virtual reality (VR) on the persecutory idea of reference (IOR) or delusions of reference (DOR) in patients with psychosis. This study examined the efficacy and safety of VR therapy in stable outpatients with psychosis and explored relationships between primary outcomes and psychological factors using path analysis.
Seventy-eight patients were randomly assigned to either the VR-treatment (VR-T) or VR-control (VR-C) group. The VR-T group viewed three 360° 3D videos or four animated videos; the VR-C group viewed the same seven videos with muted voices or 11 360° 3D videos of natural scenes. Pre- and post-assessments were performed using the Psychotic Symptom Rating Scale-Delusions (PSYRATS-D) and Revised Green et al. Paranoid Thought Scale (R-GPTS) as a primary outcome measure. Several self-rating scales measuring schema, depression, brooding, negative evaluation, attribution bias, and self-esteem were administered. Safety was assessed after sessions 1 and 10, and path models were constructed.
Between-group analysis showed a significant improvement in PSYRATS-D scores in the VR-T group compared with the VR-C group. Regarding self-rating scales, the between-group analysis revealed a significant group × time interaction only for the Social and Occupational Functioning Assessment Scale (SOFAS) score. The frequency of VR sickness was high, but its severity was mild. Fear of Negative Evaluation Scale and Beck Depression Inventory scores were found to have mediating roles.
VR therapy effectively reduced delusions in young, stable psychosis patients with mild and tolerable side effects. Future studies should develop diverse VR content for older populations.
尚无研究调查虚拟现实（VR）对精神病患者被害性牵连观念（IOR）或关系妄想（DOR）的影响。本研究检验了VR疗法对病情稳定的精神病门诊患者的疗效和安全性，并使用路径分析探讨了主要结局与心理因素之间的关系。
78名患者被随机分为VR治疗组（VR-T）或VR对照组（VR-C）。VR-T组观看三段360°3D视频或四段动画视频；VR-C组观看相同的七段静音视频或11段自然场景的360°3D视频。使用精神病症状评定量表-妄想（PSYRATS-D）和修订版格林等人偏执思维量表（R-GPTS）作为主要结局指标进行治疗前和治疗后评估。还使用了几个自评量表来测量图式、抑郁、沉思、负面评价、归因偏差和自尊。在第1次和第10次治疗后评估安全性，并构建路径模型。
组间分析显示，与VR-C组相比，VR-T组的PSYRATS-D评分有显著改善。关于自评量表，组间分析显示仅在社会和职业功能评估量表（SOFAS）评分上存在显著的组×时间交互作用。VR晕动症的发生率较高，但其严重程度较轻。发现恐惧负面评价量表和贝克抑郁量表评分具有中介作用。
VR疗法有效减少了年轻、病情稳定的精神病患者的妄想，且副作用轻微且可耐受。未来的研究应为老年人群开发多样化的VR内容。
