Virtual-reality-based cognitive behavioural therapy versus waiting list control for paranoid ideation and social avoidance in patients with psychotic disorders: a single-blind randomised controlled trial
Virtual-reality-based cognitive behavioural therapy versus waiting list control for paranoid ideation and social avoidance in patients with psychotic disorders: a single-blind randomised controlled trial
复制标题
DOI：
10.1016/s2215-0366(18)30053-1
复制
发表时间：
2018-03-01
影响因子：
64.3
通讯作者：
van der Gaag, Mark
中科院分区：
文献类型：
--
作者：
Pot-Kolder, Roos M. C. A.;Geraets, Chris N. W.;van der Gaag, Mark
背景：许多精神病患者由于猜疑和焦虑而存在持续的偏执，并回避社交场合。方法在7个荷兰精神卫生中心进行的随机对照试验中，18-65岁的门诊患者在过去一个月中被随机分为VR-CBT组(除常规治疗外)和候补名单对照组(常规治疗)，这些患者在过去一个月中被诊断为DSM-IV诊断的精神病障碍和偏执。VR-CBT包括16次个体化治疗(每次1h)。评估是在基线、治疗后(即从基线开始3个月)和6个月的随访时进行的。主要结果是社会参与，我们将其作为与他人相处的时间、短暂的偏执、感觉到的社会威胁和短暂的焦虑来运作。分析采用意向治疗。这项试验在ISRCTN注册，编号为12929657。结果在2014年4月1日至2015年12月31日期间，116名精神病患者被随机分配，58人进入VR-CBT组，58人进入等待名单对照组。与对照组相比，VR-CBT在治疗后评估中没有显著增加与他人相处的时间。短暂性妄想(b=-0。331[95%CI-0。432比-0。230]，第
Background Many patients with psychotic disorders have persistent paranoid ideation and avoid social situations because of suspiciousness and anxiety. We investigated the effects of virtual-reality-based cognitive behavioural therapy (VR-CBT) on paranoid thoughts and social participation.Methods In this randomised controlled trial at seven Dutch mental health centres, outpatients aged 18-65 years with a DSM-IV-diagnosed psychotic disorder and paranoid ideation in the past month were randomly assigned (1:1) via block randomisation to VR-CBT (in addition to treatment as usual) or the waiting list control group (treatment as usual). VR-CBT consisted of 16 individual therapy sessions (each 1 h long). Assessments were done at baseline, after treatment (ie, 3 months from baseline), and at a 6 month follow-up visit. The primary outcome was social participation, which we operationalised as the amount of time spent with other people, momentary paranoia, perceived social threat, and momentary anxiety. Analysis was by intention to treat. This trial was retrospectively registered with ISRCTN, number 12929657.Findings Between April 1, 2014, and Dec 31, 2015, 116 patients with a psychotic disorder were randomly assigned, 58 to the VR-CBT group and 58 to the waiting list control group. Compared with the control, VR-CBT did not significantly increase the amount of time spent with other people at the post-treatment assessment. Momentary paranoid ideation (b=-0 . 331 [95% CI -0 . 432 to -0 . 230], p