Virtual reality assisted cognitive behavioral therapy improves theory of mind and decreases paranoia in patients with schizophrenia: a randomized controlled trial.

INTRODUCTION

patients with schizophrenia have deficits in social cognition and functioning. Virtual reality is a 3D real-world simulation created by a computer. Virtual reality-based cognitive behavioral therapy might increase effectiveness and acceptability of treatment for these patients. This study investigated the efficacy of VR-CBT compared to traditional CBT in improving these outcomes in patients with recent-onset schizophrenia.

METHODS

In this open-label, randomized controlled trial, 60 patients with schizophrenia (36 men, 24 women) were randomized to receive either four sessions of VR-CBT or traditional CBT, in addition to pharmacological treatment. The VR environment simulated a bus trip with 11 neutral-faced avatars. Outcomes were assessed using the Positive and Negative Syndrome Scale (PANSS; positive symptom subscale), the Green Paranoid Thoughts Scale (GPTS), and the Reading the Mind in the Eyes Test (Eyes Test) at baseline and post-treatment. Data were analyzed using repeated measures ANOVA.

RESULTS

Both groups showed significant improvements in all measures (p < 0.05). However, the VR-CBT group demonstrated significantly greater reductions in PANSS (p < 0.001) and GPTS scores (p < 0.001), and a significantly greater increase in Eyes Test scores (p < 0.002) compared to the CBT group. No adverse effects were reported.

CONCLUSION

VR-CBT appears to be a promising adjunct to standard treatment for recent-onset schizophrenia, offering superior improvements in positive symptoms, paranoia, and ToM compared to traditional CBT. Further research is warranted to examine the long-term effects and underlying mechanisms of VR-CBT in this population.