Schizophrenia with paranoid features, such as persecutory delusions, can be a crippling illness. Various interventions, including medications and psychotherapy, can be plagued by problems with side effects and accessibility respectively. One group of researchers is exploring whether virtual reality could offer relief for these patients and recently published some encouraging preliminary data.

In an exploratory study, 30 patients with persecutory delusions were randomized to either exposure alone or exposure with removal of safety-seeking behaviors. Researchers used virtual recreations of common environments (subway, elevator, etc) where interactions causing anxiety were common. Then, study participants entered the environment, with the first group simply being exposed to the scenarios and using their normal defense behaviors. The second, intervention group was instructed to lower their defenses, approach the computer-controlled characters, make eye contact and so on. As the sessions progressed, more and more avatars were added to the scenarios, with up to 22 in the subway scenario and 6 in the elevator scenario. In short, this was a form of virtual reality cognitive therapy.

Participants wore the costly NVISOR SX111, a $24,000 headset and a motion-tracking system, to allow them to walk throughout the scenarios. A team of clinical psychologists and research workers carried out the patient instructions and assessments following each scenario.

Final outcome measurements included evaluation of delusional conviction reduction and real-world distress (walking to a local shop). The intervention group was found to have 22% reduction in delusion conviction, 19.6% reduction in real-world distress; interestingly the control group was also found to have a reduction in the number of participants experiencing severe paranoia, although less than the intervention group. No long-term outcomes were measured, thus the persistence of the effect observed is unknown.

The team behind the study released a video demonstrating the various virtual reality environments and also their further goals in the project. They noted that the virtual reality system used will likely be replaced in the future by the current consumer-grade systems, such as the Oculus Rift or HTC VIVE, and they hoped to further study how such systems could be utilized outside of the clinical environment. Given the proliferation of such consumer-graded virtual reality devices, and the potential for motion tracking with just a simple smartphone setup & Google Cardboard, further research with these would be welcome.

Sources: Medical Research Council