Virtual Reality Therapy Promising for Agoraphobia
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A novel virtual reality (VR) intervention significantly reduces agoraphobia in patients with psychosis, new research suggests. The cognitive-behavioral therapy–based treatment was particularly effective for patients with the highest level of avoidance of everyday situations. Immersive VR involves interactive three-dimensional computer-generated environments that produce the sensation of being in the real world. For patients with psychosis, dealing with the real world can be an anxious experience, particularly if they experience verbal or auditory hallucinations. Some may develop agoraphobia and start to avoid places or situations. A virtual environment allows patients to practice dealing with situations that make them anxious or uncomfortable and to learn to reengage in everyday situations.
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@pratap The primary outcome was the eight-item Oxford Agoraphobic Avoidance Scale (O-AS) questionnaire. This scale assesses distress and avoidance related to performing increasingly difficult everyday tasks. The researchers assessed patients at baseline, at the conclusion of the 6-week treatment, and at 26 weeks. Compared with the group that received usual care alone, the VR therapy group demonstrated a significant reduction in both agoraphobic avoidance (O-AS adjusted mean difference, -0.47; 95% CI, -0.88 to -0.06; Cohen's d, -0.18; P = .026) and distress (-4.33; 95% CI, -7.78 to -0.87; Cohen's d, -0.26; P = .014) at 6 weeks. This translates to being able to do about 1.5 more activities on the O-AS, such as going to a shopping center alone, said Freeman. Further analyses showed that VR therapy was especially effective for patients with severe agoraphobia. On average, these patients could complete two more O-AS activities at 26 weeks, said Freeman. The authors believe the intervention worked by reducing defence behaviors, such as avoiding eye contact and fearful thoughts. There was no significant difference in occurrence of adverse events between the study groups. These events, which were mild, transient, and did not affect the outcome, included side effects such as claustrophobia when using headsets.