JMIR Publications

ABSTRACT

Background:

Mental illness is one of the major causes of burden among all diseases globally. With many people being resistant to conventional evidence-based treatment, there is an unmet need for novel treatments to be implemented. Efforts to increase the effectiveness and benefits of evidence-based psychotherapy in psychiatry have led to the emergence of virtual reality (VR)-based interventions, which have shown a wide range of advantages. VR-based interventions have been developed for many psychopathologies, particularly anxiety-related disorders, but also for developmental disorders, severe mental disorders and neurocognitive disorders.

Objective:

This meta-review aimed to draw on the current state of evidence on the efficacy of VR-based interventions for psychiatric disorders by means of evaluating data provided from meta-analytical studies and evaluate the quality of evidence.

Methods:

The systematic search was performed using PubMed, PsycINFO, Web of Science and Google scholar (any time-February 2020). Meta-analyses were included so long as they quantitatively examined the efficacy of VR-based interventions for symptoms of a psychiatric disorder. To avoid overlap between meta-analyses, for each of the sub-analyses included within this meta-review, only one analysis provided from one meta-analysis was selected.

Results:

The search retrieved 11 eligible meta-analyses. The quality of evidence was variable ranging from very low to moderate quality. Several reasons, such as limited number of randomized controlled trials, lack of follow-up analysis or control group comparison, presence of heterogeneity and publication bias, are to account for lower quality evidence. Nonetheless, evidence has shown that for anxiety-related disorders VR-based interventions display overall medium to large effects in comparison to inactive controls, but no significant difference in comparison to standard evidence-based approaches. Preliminary data has highlighted that the effects appear to be sustained in time and may fare better than active controls. VR appears to show significant effects on neurocognitive disorders. Finally, there is insufficient data to classify VR as an evidence-based practice in neurodevelopmental disorders on social skills training and schizophrenia on compliance.

Conclusions:

In sum, VR provides unlimited opportunities by allowing to tailor approaches to specific complex problems and individualizing the intervention. Yet, VR-based interventions have not shown a superiority compared to usual evidence-based treatments. Future VR-based interventions should focus on developing innovative approach for complex and treatment-resistant symptoms that are difficult to address with traditional treatment. With the rise of personalized medicine, future research should achieve a better understanding of the potential factors that may play a role on VR outcomes and improve treatment.