A novel virtual reality-based theory of mind intervention for outpatients with schizophrenia: A proof-of-concept pilot study.

Schizophrenia is a severe and highly disabling mental illness. Although several pharmacological solutions are available to alleviate symptoms of schizophrenia, they do not seem to provide solution for accompanying social dysfunctions. To handle this unmet clinical need, many innovative interventions have been developed recently. Considering the promising results on this field and the development trend, characterized by the growing proportion of included interactive technology, our research team developed a novel virtual reality (VR)-based targeted theory of mind (ToM) intervention (VR-ToMIS) for stable outpatients with schizophrenia. VR-ToMIS is a nine-session long structured and individualized method that uses cognitive and behavioural therapeutic techniques in an immersive VR environment. Our study was a randomized, controlled pilot study. Twenty-one patients have been recruited and randomly allocated to either VR-ToMIS or passive VR condition. Patients assigned to passive VR condition could use the same VR software as the VR-ToMIS group, but without any interventions. Effects on psychiatric symptoms, neurocognitive and social cognitive functions, pragmatic language skills and quality of life were evaluated by using analysis of covariance. According to our results, VR-ToMIS was associated with improvements in negative symptoms, in one neurocognitive field (immediate memory), ToM and pragmatic language skills, but no significant change in quality of life scores was detected. Significant changes in VR-ToMIS group were associated with moderate to large therapeutic effects (ηp 2  = .24-.46, φ = .55-.67). On the background of the presented pilot results, VR-ToMIS is concluded to be feasible and tolerable.

[Treatment of Theory of Mind deficits in schizophrenia by using Virtual Reality, the VR-ToMIS training (Virtual Reality based Theory of Mind Intervention in Schizophrenia)].

Rapid development in information technology has been observed recently and has led to valuable developments also in healthcare. 3D-bio-printing or the virtual simulations that help the acquisition of anatomical and pathological knowledge and testing the acquired knowledge are just some of the examples. This progress can be recognized also in psychiatry. One of the most spectacular ways of using these technologies in psychiatry might be the therapeutic techniques associated with Virtual Reality (VR) simulations, which are currently available for anxiety disorders, eating disorders and addictions. A research team of the Psychiatric and Psychotherapeutic Department of the Semmelweis University has developed a Virtual Reality-based intervention that fits in with this perspective. The intervention mainly aims at Theory of Mind deficit and pragmatic language impairment in schizophrenia. In this article the current status of our research team's work will be presented. The article reviews the literature that provides the basis for the development, leads the reader through the main stages of the development process, and finally the program itself will be introduced. Process and mechanism of change associated with the intervention and the potential risks of the use of VR will also be discussed.