Abstract
Objective To conduct a systematic review about the use of virtual reality (VR) for evaluation, treatment and/or rehabilitation of patients with schizophrenia, focused on: areas, fields and objectives; methodological issues; features of the VR used; viability and efficiency of this resource. Methods Searches were performed about schizophrenia and virtual reality in PsycINFO, Academic Search Complete, MEDLINE Complete, CINAHL with Full Text, Web of Science and Business Source Premier databases, using the following keywords: [“schizophrenia”] AND [“virtual reality” OR “serious game”] AND [“treatment” OR “therapy” OR “rehabilitation”]. The search was carried out between November 2013 and June 2014 without using any search limiters. Results A total of 101 papers were identified, and after the application of exclusion criteria, 33 papers remained. The studies analysed focused on the use of VR for the evaluation of cognitive, social, perceptual and sensory skills, and the vast majority were experimental studies, with virtual reality specifically created for them. All the reviewed papers point towards a reliable and safe use of VR for evaluating and treating cognitive and social deficits in patients with schizophrenia, with different results in terms of generalisation, motivation, assertiveness and task participation rate. Some problems were highlighted, such as its high cost and a constant need for software maintenance. Conclusion The studies show that using the virtual reality may streamline traditional evaluation/rehabilitation programmes, allowing to enhance the results achieved, both in the cognitive and in the social field, helping for the legitimisation of this population’s psycho-social inclusion.
Highlights
Sixty years ago, the only treatment alternative for patients with schizophrenia was confinement in mental hospitals, where most of them would remain for the rest of their lives
One study[33], which used a sample of patients with early psychosis (50% diagnosed with schizophrenia and 50% with non-specific psychosis) was included by the reviewers since it covered important aspects related to the acceptability and safety of the use of virtual reality (VR)
This study highlights the benefits of VR for the evaluation, treatment and skill training of patients with schizophrenia, showing that this tool has the potential to become a new effective way of treating the symptoms and deficits experienced by this population
Summary
The only treatment alternative for patients with schizophrenia was confinement in mental hospitals, where most of them would remain for the rest of their lives. Second-generation or atypical anti-psychotic drugs are available which, apart from acting on the positive effects of schizophrenia, have positive results in decreasing the negative symptoms of this pathology. This result had a direct impact on the optimisation of other interventions (e.g. psycho-social, cognitive), as well as on the reduction of the number of hospitalisations. For the inclusion and maintenance of this population in society, there was a need to improve the treatment techniques in order to solve some of the remaining negative symptoms (avolia, apathy, social isolation, disorganisation) which hinder the integration of patients with schizophrenia into the different occupational performance contexts (e.g. family, study, work)[1,2,3,4]. In addition to symptom control, the treatment of schizophrenia started focusing on the improvement of this population’s social participation through competent performance in daily activities
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