Abstract
BackgroundMany patients with a psychotic disorder participate poorly in society. When psychotic disorders are in partial remission, feelings of paranoia, delusions of reference, social anxiety and self-stigmatization often remain at diminished severity and may lead to avoidance of places and people. Virtual reality exposure therapy (VRET) is an evidence-based treatment for several anxiety disorders. For patients with a psychotic disorder, the VRETp was developed to help them experience exposure to feared social situations. The present study aims to investigate the effects of VRETp on social participation in real life among patients with a psychotic disorder.Methods/designThe study is a single-blind randomized controlled trial with two conditions: the active condition, in which participants receive the virtual reality treatment together with treatment as usual (TAU), and the waiting list condition, in which participants receive TAU only. The two groups are compared at baseline, at 3 months posttreatment and at 6 months follow-up. All participants on the waiting list are also offered the virtual reality treatment after the follow-up measurements are completed. The primary outcome is social participation. Secondary outcomes are quality of life, interaction anxiety, depression and social functioning in general. Moderator and mediator analyses are conducted with stigma, cognitive schemata, cognitive biases, medication adherence, simulator sickness and presence in virtual reality. If effective, a cost-effectiveness analysis will be conducted.DiscussionResults from the posttreatment measurement can be considered strong empirical indicators of the effectiveness of VRETp. The 6-month follow-up data may provide reliable documentation of the long-term effects of the treatment on the outcome variables. Data from pre-treatment and mid-treatment can be used to reveal possible pathways of change.Trial registrationCurrent Controlled Trials: ISRCTN12929657. Date of registration: 8 September 2015
Highlights
Many patients with a psychotic disorder participate poorly in society
Green et al Paranoid Thoughts Scale (GPTS) Green et al Paranoid Thought Scales, SIAS Social Interaction Anxiety Scale, Beck Depression Inventory-II (BDI-II) Beck Depression Inventory, ISMI Internalized Stigma of Mental Illness, BCSS Brief Core Schema Scales, SBQ Safety Behavior Questionnaire – persecutory delusions, DACOBS Davos Assessment of Cognitive Biases Scale, SOFAS Social and Occupational Functioning Assessment Scale, MANSA Manchester Short Assessment of quality of life, TiC-P Trimbos/iMTA questionnaire for Costs associated with Psychiatric illness, SSQ Simulator Sickness Questionnaire, IPQ Igroup Presence Questionnaire, BARS Brief Adherence Rating Scale specific phobias showed that 76 % of the patients chose virtual reality (VR) exposure over in vivo exposure [10]
The main goal of the study is to investigate the effect of VRETp on improving social participation in patients with psychosis in real life
Summary
Many patients with a psychotic disorder participate poorly in society. When psychotic disorders are in partial remission, feelings of paranoia, delusions of reference, social anxiety and self-stigmatization often remain at diminished severity and may lead to avoidance of places and people. The present study aims to investigate the effects of VRETp on social participation in real life among patients with a psychotic disorder. When psychotic disorders are in partial remission, the remaining feelings of paranoia and delusions of reference often cause patients to avoid places and people. This conditioned avoidance does not improve with antipsychotic medication [5]
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