Alexandra Schroeder, Tabassum Rahman, Alexandra Thérond, Bryce Bogie, Hannah Matheson, Synthia Guimond

Efficacy and Feasibility of Virtual Reality Rehabilitation Interventions for Individuals with a Psychotic Disorder

Introduction

Efficacy and feasibility of virtual reality rehabilitation interventions for individuals with a psychotic disorder. Explore the efficacy and feasibility of Virtual Reality (VR) rehabilitation for individuals with psychotic disorders. This systematic review shows VR can improve cognitive, social, and vocational skills.

Abstract

Background: Despite current psychiatric care and rehabilitation interventions, functional recovery remains a struggle for many individuals with psychosis. Innovative approaches for rehabilitation should therefore be explored to help promote improved functional outcomes in these individuals. Virtual reality provides a realistic environment through which individuals with psychosis can receive rehabilitation interventions that are more ecological than traditional clinical settings. Objective: This systematic review provides an overview of the current evidence on the feasibility and efficacy of using virtual reality rehabilitation interventions for individuals with psychosis. Methods: The current systematic review followed the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Literature searches were conducted using PubMed and PsycINFO databases with the following keywords: (“cognitive” or “cognition”) OR ("social") OR ("vocational") AND (“training” or “remediation” or “rehabilitation” or “enhancement”) AND “schizophrenia” OR "schizoaffective" OR "psychosis" AND "virtual reality”. English peer-reviewed studies were included and divided into three categories 1) cognitive rehabilitation studies, 2) social skills rehabilitation studies, and 3) vocational rehabilitation studies. Results: Eleven articles were included, of which five were single arm studies (N = 58) and six were randomized controlled trials (N = 225). The majority of included studies (8) showed that virtual reality rehabilitation interventions are feasible and pleasant for individuals with psychosis. Furthermore, preliminary evidence showed that cognitive, social, and vocational skills can all be improved in individuals with psychosis through virtual reality rehabilitation interventions. Functional outcomes such as autonomy, managing housework, and work performance also improved through these interventions. Conclusions: Virtual reality rehabilitation interventions represent a unique approach to improving cognitive, social, and vocational deficits in individuals with psychosis.  However, more rigorous research in this area is necessary given that most of the included studies used small sample sizes and lacked an active control group. Nevertheless, virtual reality rehabilitation interventions may represent a promising adjunctive therapy for the treatment of psychosis. 

Review

This systematic review addresses a critical unmet need in mental health: improving functional recovery for individuals with psychotic disorders. Despite existing psychiatric care, many individuals struggle with daily functioning, prompting a search for innovative rehabilitation strategies. Virtual reality (VR) interventions are proposed as a promising avenue, offering a more ecological and realistic environment for rehabilitation compared to traditional clinical settings. The review's objective is to comprehensively synthesize the current evidence regarding the feasibility and efficacy of VR-based rehabilitation for this population, positioning it as a potentially transformative adjunctive therapy. Adhering to PRISMA guidelines, the authors conducted thorough literature searches across PubMed and PsycINFO, utilizing a focused set of keywords to identify relevant English peer-reviewed studies. The review ultimately included eleven articles, comprising five single-arm studies (N=58) and six randomized controlled trials (N=225), which were categorized into cognitive, social, and vocational rehabilitation domains. The findings robustly indicate that VR rehabilitation interventions are largely feasible and well-received by individuals with psychosis. Furthermore, preliminary evidence suggests these interventions can lead to improvements across cognitive, social, and vocational skills, extending to tangible functional outcomes such as autonomy, managing housework, and work performance. While the preliminary results are encouraging, the authors appropriately highlight several important limitations that temper broad conclusions. The included studies predominantly suffered from small sample sizes and often lacked active control groups, which can limit the generalizability and causal inference of the reported benefits. Despite these methodological caveats, the review concludes that VR rehabilitation represents a unique and promising approach to address the multifaceted deficits experienced by individuals with psychosis. Consequently, the authors strongly advocate for more rigorous future research, particularly studies with larger cohorts and robust experimental designs, to solidify the evidence base and fully establish VR as an effective and potentially vital adjunctive therapy in the treatment of psychotic disorders.

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