JMIR Publications

ABSTRACT

Background:

Stress management is a cornerstone of psychiatric treatments. However, stress-reducing interventions (e.g., relaxation exercises) are challenging for people with mental health problems. We developed a virtual reality (VR) self-management relaxation tool with immersive 360o nature videos and interactive animated elements.

Objective:

To investigate the immediate and short-term effects of VR relaxation (VRelax) on stress level, mood states and symptoms in patients with a psychiatric disorder, compared to standard relaxation exercises.

Methods:

A randomized cross-over trial was conducted in 50 patients receiving ambulatory treatment for anxiety, psychotic, depressive or bipolar disorder. Participants were randomly assigned to start with VRelax or standard relaxation, and used both interventions for 10 days at home. They completed Visual Analogue Scales (VAS) of stress level and mood states before and after each session. Global perceived stress and psychiatric symptoms were measured before and after both intervention periods. Treatment effects were analyzed with multilevel repeated-measures regression models and two-way ANOVA.

Results:

Both VRelax and standard relaxation exercises led to a statistically significant immediate reduction of stress and improvement of mood states. Compared to standard relaxation, VRelax resulted in a significantly greater immediate improvement of anxiety (B=-4.30, 95%CI=-5.86;-2.73), sadness (B=-3.65, 95%CI =-5.39;-1.91), cheerfulness (B=3.67, 95%CI=2.15;5.18), overall positive mood (B=7.59, 95%CI=2.28;12.89), and overall negative mood (B=10.88, 95%CI=5.89;15.87). There were no significant differences between short-term effects of the two treatments on symptoms and global perceived stress.

Conclusions:

If the results of this trial are replicated and extended, VRelax may provide a much needed effective self-management stress intervention to enhance psychiatric treatments. Clinical Trial: Dutch trial register, number NTR 7294.