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Virtual Reality-Based Treatment Shows No Effect on Social Cognition in Patients With Schizophrenia
Virtual reality (VR)-based social cognition training (SCT) program “DiSCoVR” was not shown to improve social cognition or functioning in patients with schizophrenia, according to a study published in Schizophrenia Bulletin.
“This lack of efficacy may indicate that current SCT protocols are relatively unsuitable for improving social functioning,” authors noted. “Previous studies showed small to moderate effects on higher order social cognition, but the SCT approach may need critical reevaluation, as it may not sufficiently lead to functional improvement.”
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The single-blind study was carried out at 5 mental health centers in the Netherlands between April 9, 2018, and December 9, 2020. Patients with a diagnosed psychotic disorder were randomly assigned to either DiSCoVR (n = 41) or active control VR relaxation program “VRelax” (n = 40) and completed 16 twice-weekly sessions. DiSCoVR held modules on facial affect recognition, social perception theory of mind, and applications of social cognition in social interactions while VRelax focused on relaxation and stress reduction. Patients were assessed 3 times throughout the study by blind assessors, once at baseline, once following treatment, and once 3 months after treatment.
No time by condition interactions were found, indicating an absence of treatment effects. Over the course of the study, 3 serious adverse events (SAEs) were reported—2 in the DiSCoVR group and 1 in the VRelax group. All 3 events involved psychiatric hospitalization but were all deemed unrelated to participation in the study by treating clinicians. Some patients also reported experiencing nausea, with a reported mean Simulator Sickness Questionnaire (SSQ) score of 3.1 in the DiSCoVR group and 2.0 in the VRelax group.
“Therefore, as has been shown for cognitive remediation therapy (CRT), integration of SCT with other treatments may be necessary, such as cognitive behavioral therapy, CRT, behavioral activation, and/or psychosocial rehabilitation programs such as Individual Placement and Support,” authors concluded in the study. “Ultimately, focusing on any single process may be insufficient, as social dysfunction is caused by an interplay of many different factors. A more holistic approach may be necessary, and whether or how SCT fits into this approach, requires further investigation.”
One author, W. Veling, is co-founder, chief scientific officer, and shareholder of VRelax BV, the company that developed VRelax.
The study was also interrupted by COVID-19, causing a higher rate of patient dropouts and impacting researchers’ ability to reach their desired sample size.
