Exploring the Benefits of Virtual Reality-Assisted Therapy Following Cognitive-Behavioral Therapy for Auditory Hallucinations in Patients with Treatment-Resistant Schizophrenia: A Proof of Concept.
auditory verbal hallucinations
avatar
cognitive behavioral therapy
treatment resistant schizophrenia
virtual reality
Journal
Journal of clinical medicine
ISSN: 2077-0383
Titre abrégé: J Clin Med
Pays: Switzerland
ID NLM: 101606588
Informations de publication
Date de publication:
30 Sep 2020
30 Sep 2020
Historique:
received:
26
08
2020
revised:
20
09
2020
accepted:
27
09
2020
entrez:
3
10
2020
pubmed:
4
10
2020
medline:
4
10
2020
Statut:
epublish
Résumé
Combining cognitive behavioral therapy (CBT) for psychosis with another psychosocial intervention comprising virtual reality (VR)-assisted therapy (VRT) may improve targeted outcomes in treatment-resistant schizophrenia patients. Ten participants having followed CBT were part of our comparative clinical trial comparing VRT to CBT and were selected at the end of the study as they desired to continue to achieve improvements with VRT (CBT + VRT). Clinical assessments were administered before/after treatments and at follow-ups. Changes in outcomes were examined using linear mixed-effects models. To gain a more in depth understanding on CBT + VRT, therapists' notes, and open interviews on a sub-group of patients were qualitatively analyzed. Findings showed that the sequence of both interventions was appreciated by all patients. Several significant improvements were found throughout time points on auditory verbal hallucinations, beliefs about voices, depressive symptoms, symptoms of schizophrenia and quality of life. Although most of these improvements were in similar range to those observed in our comparative trial, effects of CBT + VRT on depressive symptoms and symptoms of schizophrenia were larger than those found for either intervention alone. This proof of concept is the first to merge gold-standard CBT with VRT for treatment refractory voices and to suggest a certain synergistic effect.
Sections du résumé
BACKGROUND
BACKGROUND
Combining cognitive behavioral therapy (CBT) for psychosis with another psychosocial intervention comprising virtual reality (VR)-assisted therapy (VRT) may improve targeted outcomes in treatment-resistant schizophrenia patients.
METHODS
METHODS
Ten participants having followed CBT were part of our comparative clinical trial comparing VRT to CBT and were selected at the end of the study as they desired to continue to achieve improvements with VRT (CBT + VRT). Clinical assessments were administered before/after treatments and at follow-ups. Changes in outcomes were examined using linear mixed-effects models. To gain a more in depth understanding on CBT + VRT, therapists' notes, and open interviews on a sub-group of patients were qualitatively analyzed.
RESULTS
RESULTS
Findings showed that the sequence of both interventions was appreciated by all patients. Several significant improvements were found throughout time points on auditory verbal hallucinations, beliefs about voices, depressive symptoms, symptoms of schizophrenia and quality of life. Although most of these improvements were in similar range to those observed in our comparative trial, effects of CBT + VRT on depressive symptoms and symptoms of schizophrenia were larger than those found for either intervention alone.
CONCLUSION
CONCLUSIONS
This proof of concept is the first to merge gold-standard CBT with VRT for treatment refractory voices and to suggest a certain synergistic effect.
Identifiants
pubmed: 33007909
pii: jcm9103169
doi: 10.3390/jcm9103169
pmc: PMC7601104
pii:
doi:
Types de publication
Journal Article
Langues
eng
Subventions
Organisme : Pinel Foundation
ID : N/A
Organisme : Services et Recherches Psychiatriques AD
ID : N/A
Organisme : Levesque Foundation
ID : N/A
Organisme : Otsuka Canada Pharmaceuticals Inc
ID : N/A
Références
Psychiatr Clin North Am. 2016 Jun;39(2):239-65
pubmed: 27216902
Front Psychol. 2015 Dec 21;6:1933
pubmed: 26733919
Psychosis. 2021;13(1):78-84
pubmed: 33889197
Schizophr Res. 2014 Jun;156(1):30-7
pubmed: 24731619
Aust N Z J Psychiatry. 2005 Jan-Feb;39(1-2):1-30
pubmed: 15660702
Br J Psychiatry. 2000 Sep;177:229-32
pubmed: 11040883
Psychiatr Serv. 2014 Jul;65(7):874-80
pubmed: 24686725
J Dual Diagn. 2019 Jan-Mar;15(1):8-15
pubmed: 30445892
Am J Psychiatry. 2014 May;171(5):523-38
pubmed: 24525715
Schizophr Res. 2018 Jul;197:249-252
pubmed: 29129509
Behav Sci (Basel). 2014 Nov 06;4(4):437-47
pubmed: 25431447
Schizophr Res. 2018 Jul;197:176-181
pubmed: 29486956
Neuropsychiatr Dis Treat. 2016 Jun 15;12:1397-410
pubmed: 27366072
Clin Psychol Rev. 2016 Apr;45:183-92
pubmed: 27048980
Indian J Psychiatry. 2020 Jan;62(Suppl 2):S251-S262
pubmed: 32055067
Neurobiol Dis. 2019 Nov;131:104257
pubmed: 30170114
Br J Psychiatry. 2013 Jun;202:428-33
pubmed: 23429202
Schizophr Res. 2012 May;137(1-3):246-50
pubmed: 22356801
Schizophr Res. 2011 Aug;130(1-3):234-7
pubmed: 21441016
Behav Cogn Psychother. 2011 Mar;39(2):129-38
pubmed: 21062528
Qual Life Res. 2005 Sep;14(7):1693-703
pubmed: 16119181
Psychol Med. 2001 Feb;31(2):189-95
pubmed: 11232907
Can J Psychiatry. 2014 Jan;59(1):18-25
pubmed: 24444320
Can J Psychiatry. 2010 Mar;55(3):172-9
pubmed: 20370968
Behav Res Ther. 2009 Dec;47(12):1090-5
pubmed: 19698938
Clin Psychol Psychother. 2018 Nov;25(6):878-885
pubmed: 30221431
Lancet Psychiatry. 2018 Jan;5(1):31-40
pubmed: 29175276
J Psychopharmacol. 2019 Apr;33(4):423-435
pubmed: 30696332
Schizophr Bull. 1987;13(2):261-76
pubmed: 3616518
Br J Psychiatry. 1990 Mar;156:388-94
pubmed: 2346840
Schizophr Res. 2015 Oct;168(1-2):377-80
pubmed: 26255082
Clin Psychol Psychother. 2018 Sep;25(5):701-709
pubmed: 29961961
J Anxiety Disord. 2019 Jan;61:3-17
pubmed: 30057346
Psychol Med. 1999 Jul;29(4):879-89
pubmed: 10473315
Can J Psychiatry. 2017 Nov;62(11):772-777
pubmed: 28655284
Schizophr Res Treatment. 2018 Mar 1;2018:9898654
pubmed: 29686902
Med Hypotheses. 2013 Jun;80(6):689-91
pubmed: 23490199
Am J Psychiatry. 2017 Mar 1;174(3):216-229
pubmed: 27919182
BMC Psychol. 2018 Jul 17;6(1):32
pubmed: 30016999
Psychiatry Res. 2018 Jan;259:95-103
pubmed: 29035759
Psychopharmacol Bull. 1993;29(2):321-6
pubmed: 8290681
Schizophr Bull. 2020 May 06;:
pubmed: 32372082
Schizophr Bull. 2014 Jul;40 Suppl 4:S202-12
pubmed: 24936081
Am J Psychiatry. 2004 Feb;161(2 Suppl):1-56
pubmed: 15000267
Nord J Psychiatry. 2011 Jun;65(3):162-74
pubmed: 21563994
Psychiatry Res Neuroimaging. 2019 Apr 30;286:45-52
pubmed: 30897449
Schizophr Bull. 2010 Jan;36(1):136-42
pubmed: 19880824
Front Psychiatry. 2018 Apr 16;9:131
pubmed: 29713292
Neuropsychol Rehabil. 2008 Jan;18(1):45-64
pubmed: 18058387
Schizophr Res. 2019 Jan;203:55-61
pubmed: 29169775
Psychol Res Behav Manag. 2015 Feb 18;8:63-9
pubmed: 25733937
Can J Psychiatry. 2007 Mar;52(3):182-90
pubmed: 17479527
Cyberpsychol Behav. 2005 Jun;8(3):220-30; discussion 231-40
pubmed: 15971972
Int Clin Psychopharmacol. 2014 Mar;29(2):63-76
pubmed: 23995856
J Nerv Ment Dis. 2011 Aug;199(8):520-6
pubmed: 21814072
Br J Psychiatry. 2014 Jan;204(1):20-9
pubmed: 24385461
Stud Health Technol Inform. 2004;99:37-54
pubmed: 15295145