Efficacy of immersive PTSD treatments: A systematic review of virtual and augmented reality exposure therapy and a meta-analysis of virtual reality exposure therapy.


Journal

Journal of psychiatric research
ISSN: 1879-1379
Titre abrégé: J Psychiatr Res
Pays: England
ID NLM: 0376331

Informations de publication

Date de publication:
Nov 2021
Historique:
received: 18 05 2020
revised: 08 10 2020
accepted: 12 11 2020
pubmed: 30 11 2020
medline: 3 11 2021
entrez: 29 11 2020
Statut: ppublish

Résumé

Virtual reality exposure therapy (VRET) and augmented reality exposure therapy (ARET) are digitally assisted psychotherapies that potentially enhance posttraumatic stress disorder (PTSD) treatment by increasing a patient's sense of presence during exposure therapy. This study aimed to systematically review current evidence regarding the efficacy of VRET and ARET as PTSD treatment. A systematic electronic database search, a systematic quality assessment and two meta-analyses were conducted in accordance with PRISMA guidelines. Eleven studies on the efficacy of VRET for PTSD (n = 438) were found, but no studies on the efficacy of ARET. The majority of VRET studies were of a low quality and had heterogeneous results. Meta-analyses showed VRET outperformed waitlist control (standardized mean difference -0.64 (95% CI -1.05 to -0.22)) while no significant difference was found between VRET and active treatment conditions (standardized mean difference -0.25 (95% CI -0.77 to 0.27)). VRET was superior to waitlist control groups and as effective as other psychotherapies. However, the results showed considerable heterogeneity due to the low number of studies and variety of VRET methods. VRET may be an effective alternative to current treatments and shows promise for the treatment of PTSD patients that have not responded to previous treatment. Future research should focus on high quality RCTs, including information on side effects and adverse events, with sufficient numbers of participants. This study recognizes a research gap regarding the efficacy of ARET, while it may have potential for PTSD treatment.

Sections du résumé

BACKGROUND BACKGROUND
Virtual reality exposure therapy (VRET) and augmented reality exposure therapy (ARET) are digitally assisted psychotherapies that potentially enhance posttraumatic stress disorder (PTSD) treatment by increasing a patient's sense of presence during exposure therapy. This study aimed to systematically review current evidence regarding the efficacy of VRET and ARET as PTSD treatment.
METHODS METHODS
A systematic electronic database search, a systematic quality assessment and two meta-analyses were conducted in accordance with PRISMA guidelines.
RESULTS RESULTS
Eleven studies on the efficacy of VRET for PTSD (n = 438) were found, but no studies on the efficacy of ARET. The majority of VRET studies were of a low quality and had heterogeneous results. Meta-analyses showed VRET outperformed waitlist control (standardized mean difference -0.64 (95% CI -1.05 to -0.22)) while no significant difference was found between VRET and active treatment conditions (standardized mean difference -0.25 (95% CI -0.77 to 0.27)).
CONCLUSION CONCLUSIONS
VRET was superior to waitlist control groups and as effective as other psychotherapies. However, the results showed considerable heterogeneity due to the low number of studies and variety of VRET methods. VRET may be an effective alternative to current treatments and shows promise for the treatment of PTSD patients that have not responded to previous treatment. Future research should focus on high quality RCTs, including information on side effects and adverse events, with sufficient numbers of participants. This study recognizes a research gap regarding the efficacy of ARET, while it may have potential for PTSD treatment.

Identifiants

pubmed: 33248674
pii: S0022-3956(20)31089-X
doi: 10.1016/j.jpsychires.2020.11.030
pii:
doi:

Types de publication

Journal Article Meta-Analysis Review Systematic Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

516-527

Informations de copyright

Copyright © 2020 The Authors. Published by Elsevier Ltd.. All rights reserved.

Auteurs

L V Eshuis (LV)

Amsterdam University Medical Centers, University of Amsterdam, Department of Psychiatry, Meibergdreef 9, 1105 AZ, Amsterdam, the Netherlands. Electronic address: l.v.eshuis@amsterdamumc.nl.

M J van Gelderen (MJ)

Foundation Centrum'45, Arq Psychotrauma Expert Group, Nienoord 13, 1112 XE, Diemen, the Netherlands. Electronic address: m.van.gelderen@centrum45.nl.

M van Zuiden (M)

Amsterdam University Medical Centers, University of Amsterdam, Department of Psychiatry, Meibergdreef 9, 1105 AZ, Amsterdam, the Netherlands. Electronic address: m.vanzuiden@amsterdamumc.nl.

M J Nijdam (MJ)

Amsterdam University Medical Centers, University of Amsterdam, Department of Psychiatry, Meibergdreef 9, 1105 AZ, Amsterdam, the Netherlands; Foundation Centrum'45, Arq Psychotrauma Expert Group, Nienoord 13, 1112 XE, Diemen, the Netherlands. Electronic address: m.j.nijdam@amsterdamumc.nl.

E Vermetten (E)

Leiden University Medical Center, Department of Psychiatry, Postbus 9600, 2300 RC, Leiden, the Netherlands; Military Mental Health-Research, Ministry of Defence, Utrecht, the Netherlands; Arq Psychotrauma Expert Group, Nienoord 13, 1112 XE, Diemen, the Netherlands. Electronic address: h.g.j.m.vermetten@lumc.nl.

M Olff (M)

Amsterdam University Medical Centers, University of Amsterdam, Department of Psychiatry, Meibergdreef 9, 1105 AZ, Amsterdam, the Netherlands; Arq Psychotrauma Expert Group, Nienoord 13, 1112 XE, Diemen, the Netherlands. Electronic address: m.olff@amsterdamumc.nl.

A Bakker (A)

Amsterdam University Medical Centers, University of Amsterdam, Department of Psychiatry, Meibergdreef 9, 1105 AZ, Amsterdam, the Netherlands. Electronic address: a.bakker@amsterdamumc.nl.

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Classifications MeSH