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Zhang J, Chen M, Yan J, Wang C, Deng H, Wang J, Gu J, Wang D, Li W, Wang C. Effects of virtual reality-based cue exposure therapy on craving and physiological responses in alcohol-dependent patients-a randomised controlled trial. BMC Psychiatry 2023; 23:951. [PMID: 38110900 PMCID: PMC10726483 DOI: 10.1186/s12888-023-05426-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Accepted: 11/30/2023] [Indexed: 12/20/2023] Open
Abstract
BACKGROUND Cue exposure therapy is used to treat alcohol dependence. However, its effectiveness is controversial due to the limitations of the clinical treatment setting. Virtual reality technology may improve the therapeutic effect. The aim of this study is to explore whether virtual reality-based cue exposure therapy can reduce the psychological craving and physiological responses of patients with alcohol dependence. METHODS Forty-four male alcohol-dependent patients were recruited and divided into the study group (n = 23) and the control group (n = 21) according to a random number table. The control group received only conventional clinical treatment for alcohol dependence. The study group received conventional clinical treatment with the addition of VR cue exposure (treatment). The primary outcome was to assess psychological craving and physiological responses to cues of patients before and after treatment. RESULTS After virtual reality-based cue exposure therapy, the changes in VAS and heart rate before and after cue exposure in the study group were significantly lower than those in the control group (P < 0.05), while the changes in skin conductance and respiration between the study group and the control group were not significantly different (P > 0.05). The changes in VAS and heart rate before and after cue exposure in the study group were significantly lower than those before treatment (P < 0.05), while the changes in skin conductance and respiration were not significantly different from those before treatment (P > 0.05). The changes in VAS, heart rate, skin conductance and respiration before and after cue exposure in the control group were not significantly different from those before treatment (P > 0.05). CONCLUSION Virtual reality-based cue exposure therapy can reduce the psychological craving and part of the physiological responses of alcohol-dependent patients during cue exposure in the short term and may be helpful in the treatment of alcohol dependence. TRIAL REGISTRATION The study protocol was registered at the China Clinical Trial Registry on 26/02/2021 ( www.chictr.org.cn ; ChiCTR ID: ChiCTR2100043680).
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Affiliation(s)
- Junjun Zhang
- Department of Psychiatry, The Second Affiliated Hospital of Xinxiang Medical University, 207# QianJin Road, Xinxiang, Henan, 453000, China
| | - Ming Chen
- Department of Psychiatry, The Second Affiliated Hospital of Xinxiang Medical University, 207# QianJin Road, Xinxiang, Henan, 453000, China
| | - Junli Yan
- Department of Psychiatry, The Second Affiliated Hospital of Xinxiang Medical University, 207# QianJin Road, Xinxiang, Henan, 453000, China
| | - Chaojun Wang
- Department of Psychiatry, The Second Affiliated Hospital of Xinxiang Medical University, 207# QianJin Road, Xinxiang, Henan, 453000, China
| | - Hongdu Deng
- Department of Psychiatry, The Second Affiliated Hospital of Xinxiang Medical University, 207# QianJin Road, Xinxiang, Henan, 453000, China
- Department of Community Health, Advanced Medical and Dental Institute, Universiti Sains Malaysia, Kepala Batas, Pulau Pinang, Malaysia
| | - Jiali Wang
- Department of Psychiatry, The Second Affiliated Hospital of Xinxiang Medical University, 207# QianJin Road, Xinxiang, Henan, 453000, China
| | - Jiapeng Gu
- Department of Psychiatry, The Second Affiliated Hospital of Xinxiang Medical University, 207# QianJin Road, Xinxiang, Henan, 453000, China
| | - Dan Wang
- Department of Psychiatry, The Second Affiliated Hospital of Xinxiang Medical University, 207# QianJin Road, Xinxiang, Henan, 453000, China
| | - Wenhui Li
- Department of Psychiatry, The Second Affiliated Hospital of Xinxiang Medical University, 207# QianJin Road, Xinxiang, Henan, 453000, China.
| | - Chuansheng Wang
- Department of Psychiatry, The Second Affiliated Hospital of Xinxiang Medical University, 207# QianJin Road, Xinxiang, Henan, 453000, China.
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Nègre F, Lemercier-Dugarin M, Kahn-Lewin C, Gomet R, Zerdazi EHM, Zerhouni O, Romo L. Virtual reality efficiency as exposure therapy for alcohol use: A systematic literature review. Drug Alcohol Depend 2023; 253:111027. [PMID: 38006671 DOI: 10.1016/j.drugalcdep.2023.111027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 10/27/2023] [Accepted: 10/28/2023] [Indexed: 11/27/2023]
Abstract
Virtual reality is an immersive technology that can be used as a tool in the treatment of disorders linked to substance use disorders, such as alcohol use disorder. This systematic review of the literature examines the effectiveness of virtual reality as exposure therapy for heavy social drinkers, defined as people who regularly consume alcohol in a variety of social contexts, with or without a diagnosis of alcohol use disorder. The current review includes ten studies with a total of 377 participants. Most participants were adult men (61.03%), with an age average of 44.1 years [± 7.42] and alcohol use ranging from light to heavy. Although studies show heterogeneous results, the use of virtual reality cue exposure therapies has shown greater improvement in terms of craving reduction for patients suffering from alcohol use disorder. Studies have also shown that the realism of the virtual environment can influence levels of craving and anxiety, both in heavy social drinkers. In addition, the use of virtual reality has proven to increase feeling of self-efficacy and decrease the tendency to engage in automatic drinking behaviors. However, the review also mentions the necessity of larger research to determine the efficiency of virtual reality as a therapeutic treatment for alcohol use disorder, whilst considering comorbidities and treatment background, especially for resistant patients.
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Affiliation(s)
- Fanny Nègre
- Université Paris Nanterre, Laboratoire CLIPSYD, Nanterre, 92000 France; APHP, Hôpitaux Universitaires Henri Mondor, DMU IMPACT, Hôpital Albert Chenevier, Service d'addictologie, Créteil 94010, France.
| | - Maud Lemercier-Dugarin
- Université de Caen Normandie, Laboratoire de Psychologie Caen Normandie (LPCN, UR 7452), Caen 14000, France
| | - Chava Kahn-Lewin
- Université Paris Nanterre, Laboratoire CLIPSYD, Nanterre, 92000 France
| | - Romain Gomet
- APHP, Hôpitaux Universitaires Henri Mondor, DMU IMPACT, Hôpital Albert Chenevier, Service d'addictologie, Créteil 94010, France
| | - El-Hadi Mohammed Zerdazi
- APHP, Hôpitaux Universitaires Henri Mondor, DMU IMPACT, Hôpital Albert Chenevier, Service d'addictologie, Créteil 94010, France; Université Paris Est Créteil, INSERM U995, IMRB, Translational Neuropsychiatry laboratory, Créteil F-94010, France
| | - Oulmann Zerhouni
- Université Rouen Normandie, Normandie Univ, CRFDP UR 7475, Rouen F-76000, France; Laboratoire Parisien de Psychologie Sociale, EA 4386 (équipe PS2C), Nanterre Cedex 92001, France
| | - Lucia Romo
- Université Paris Nanterre, Laboratoire CLIPSYD, Nanterre, 92000 France; APHP, Hôpital Universitaire Raymond Poincaré, Garches 92380, France; Université Paris Saclay, INSERM CESP 1018 UPS, Villejuif 94807, France
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3
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Barillot L, Chauvet C, Besnier M, Jaafari N, Solinas M, Chatard A. Effect of environmental enrichment on relapse rates in patients with severe alcohol use disorder: protocol for a randomised controlled trial. BMJ Open 2023; 13:e069249. [PMID: 37173113 PMCID: PMC10186436 DOI: 10.1136/bmjopen-2022-069249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Accepted: 04/06/2023] [Indexed: 05/15/2023] Open
Abstract
INTRODUCTION Alcohol use disorder (AUD) ranks among the most prevalent psychiatric disorders worldwide. Despite current treatments, more than half of patients relapse within weeks after treatment. In animal models, exposure to environmental enrichment (EE) has been shown to be a promising approach to reduce relapse. However, controlled, multimodal EE is difficult to transpose to humans. To address this gap, this study aims at assessing the effectiveness of exposure to a newly designed EE protocol during AUD treatment in reducing relapse to alcohol use. Our EE will allow an enhancement of the standard intervention, and will combine several promising enrichment factors identified in the literature-physical activity, cognitive stimulation, mindfulness and virtual reality (VR). METHODS AND ANALYSIS A randomised controlled trial involving 135 participants receiving treatment for severe AUD will be conducted. Patients will be randomised to an intervention enhancement group or a control group. The enhanced intervention will consist of six 40-min sessions of EE spread over 9 days. During the first 20 min of these sessions, patients will practise mindfulness in multisensory VR, in virtual environments designed to practise mindfulness and use it to regulate craving induced by virtual cues or stress. Then, participants will practise indoor cycling combined with cognitive training exercises. The control group will undergo standard management for AUD. The primary outcome is relapse assessed at 2 weeks after treatment, using a questionnaire and biological indicators. Relapse will be defined as drinking at least five drinks per occasion or drinking at least five times a week. It is predicted that the group receiving the EE intervention will have a lower relapse rate than the control group. The secondary outcomes are relapse at 1 month and 3 months after treatment, craving and drug-seeking behaviour, mindfulness skills acquisition and the effect of the intervention enhancement on the perceived richness of the daily environment, assessed by questionnaires and neuropsychological tasks. ETHICS AND DISSEMINATION All participants have to give written informed consent to the investigator. This study is approved by the Ethics Committee Nord Ouest IV of Lille (reference number 2022-A01156-37). Results will be disseminated through presentations, peer-reviewed journals and seminar conferences. All information on ethical considerations and open science practices can be accessed at https://osf.io/b57uj/ TRIAL REGISTRATION NUMBER: NCT05577741.
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Affiliation(s)
- Lila Barillot
- Université de Poitiers, Centre de Recherches sur la Cognition et l'Apprentissage, Poitiers, Nouvelle-Aquitaine, France
- Unité de Recherche Clinique Pierre Deniker, Centre Hospitalier Henri Laborit, Poitiers, Poitou-Charentes, France
| | - Claudia Chauvet
- Unité de Recherche Clinique Pierre Deniker, Centre Hospitalier Henri Laborit, Poitiers, Poitou-Charentes, France
- Service Hospitalo-Universitaire de Psychiatrie et de Psychologie Médicale, Centre Hospitalier Henri Laborit, Poitiers, France
| | - Marc Besnier
- Université de Poitiers, Centre de Recherches sur la Cognition et l'Apprentissage, Poitiers, Nouvelle-Aquitaine, France
- Unité de Recherche Clinique Pierre Deniker, Centre Hospitalier Henri Laborit, Poitiers, Poitou-Charentes, France
| | - Nematollah Jaafari
- Université de Poitiers, Centre de Recherches sur la Cognition et l'Apprentissage, Poitiers, Nouvelle-Aquitaine, France
- Unité de Recherche Clinique Pierre Deniker, Centre Hospitalier Henri Laborit, Poitiers, Poitou-Charentes, France
| | - Marcello Solinas
- Unité de Recherche Clinique Pierre Deniker, Centre Hospitalier Henri Laborit, Poitiers, Poitou-Charentes, France
- Université de Poitiers, Laboratoire de Neurosciences Expérimentales et Cliniques U1084, Poitiers, France
| | - Armand Chatard
- Université de Poitiers, Centre de Recherches sur la Cognition et l'Apprentissage, Poitiers, Nouvelle-Aquitaine, France
- Unité de Recherche Clinique Pierre Deniker, Centre Hospitalier Henri Laborit, Poitiers, Poitou-Charentes, France
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4
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Kiyak C, Simonetti ME, Norton S, Deluca P. The efficacy of cue exposure therapy on alcohol use disorders: A quantitative meta-analysis and systematic review. Addict Behav 2023; 139:107578. [PMID: 36563480 DOI: 10.1016/j.addbeh.2022.107578] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2022] [Revised: 11/13/2022] [Accepted: 12/08/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND Cue exposure therapy (CET) techniques involves repeated and controlled exposures to alcohol stimuli which rest upon the well-established principles of Pavlovian extinction (Byrne et al., 2019). However, the efficacy of CET while treating alcohol use disorders (AUDs) is still a matter of debate. Therefore, we aimed to investigate the efficacy of CET on AUDs by using previous meta-analysis study on the same topic from Mellentin et al. (2017) as a base. METHODS A computer-assisted search of relevant articles identified 879 studies in Medline, PsycInfo and Embase, of which 11 studies (published between 1992 and 2019) were selected. Three outcome measures were extracted: alcohol consumption defined as drinks per day (drinking intensity) and alcohol reduction defined as drinking days and relapse (drinking frequency). This study is registered with PROSPERO (Registration no: #CRD42021259077). RESULTS The present meta-analytical review found small to medium effect on drinks per day (g = -0.35; 95 %CI -0.72 to 0.03), drinking days (g = -0.30; 95 %CI -0.54 to -0.06) and relapse (OR = -0.58; 95 %CI 0.29 to 1.15) while investigating the efficacy of CET on AUDs. GRADE assessment was used to evaluate the overall quality, and it was assessed as low. Regarding Risk of Bias, the studies in this systematic review were evaluated with "some concerns". CONCLUSION The present meta-analysis demonstrated that CET has small to medium effect on drinks per day, drinking days and relapse. Future research should strive to conduct larger scale multi-site CET trials with additional methodological innovations and increase retention.
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Affiliation(s)
- Ceyda Kiyak
- School of Psychology, University of East Anglia, Norwich, United Kingdom.
| | | | - Sam Norton
- Institute of Psychiatry Psychology & Neuroscience, King's College London, London, United Kingdom
| | - Paolo Deluca
- Institute of Psychiatry Psychology & Neuroscience, King's College London, London, United Kingdom
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5
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Valyear MD, LeCocq MR, Brown A, Villaruel FR, Segal D, Chaudhri N. Learning processes in relapse to alcohol use: lessons from animal models. Psychopharmacology (Berl) 2023; 240:393-416. [PMID: 36264342 DOI: 10.1007/s00213-022-06254-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Accepted: 10/02/2022] [Indexed: 11/29/2022]
Abstract
RATIONALE Alcohol use is reliably preceded by discrete and contextual stimuli which, through diverse learning processes, acquire the capacity to promote alcohol use and relapse to alcohol use. OBJECTIVE We review contemporary extinction, renewal, reinstatement, occasion setting, and sex differences research within a conditioning framework of relapse to alcohol use to inform the development of behavioural and pharmacological therapies. KEY FINDINGS Diverse learning processes and corresponding neurobiological substrates contribute to relapse to alcohol use. Results from animal models indicate that cortical, thalamic, accumbal, hypothalamic, mesolimbic, glutamatergic, opioidergic, and dopaminergic circuitries contribute to alcohol relapse through separable learning processes. Behavioural therapies could be improved by increasing the endurance and generalizability of extinction learning and should incorporate whether discrete cues and contexts influence behaviour through direct excitatory conditioning or occasion setting mechanisms. The types of learning processes that most effectively influence responding for alcohol differ in female and male rats. CONCLUSION Sophisticated conditioning experiments suggest that diverse learning processes are mediated by distinct neural circuits and contribute to relapse to alcohol use. These experiments also suggest that gender-specific behavioural and pharmacological interventions are a way towards efficacious therapies to prevent relapse to alcohol use.
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Affiliation(s)
- Milan D Valyear
- Center for Studies in Behavioral Neurobiology, Department of Psychology, Concordia University, Montréal, QC, Canada. .,Department of Psychology, McGill University, 1205 Ave. Dr. Penfield, Room N8/5, Montréal, QC, H3A 1B1, Canada.
| | - Mandy R LeCocq
- Center for Studies in Behavioral Neurobiology, Department of Psychology, Concordia University, Montréal, QC, Canada
| | - Alexa Brown
- Center for Studies in Behavioral Neurobiology, Department of Psychology, Concordia University, Montréal, QC, Canada
| | - Franz R Villaruel
- Center for Studies in Behavioral Neurobiology, Department of Psychology, Concordia University, Montréal, QC, Canada
| | - Diana Segal
- Center for Studies in Behavioral Neurobiology, Department of Psychology, Concordia University, Montréal, QC, Canada
| | - Nadia Chaudhri
- Center for Studies in Behavioral Neurobiology, Department of Psychology, Concordia University, Montréal, QC, Canada
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6
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Adolphe A, Quinlan E, Calvert F. Examining the Experiences of and Perceived Treatment Needs for Social Anxiety and Substance Use Among Homeless Men. Int J Ment Health Addict 2022. [DOI: 10.1007/s11469-021-00737-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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7
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Geraets CNW, Wallinius M, Sygel K. Use of Virtual Reality in Psychiatric Diagnostic Assessments: A Systematic Review. Front Psychiatry 2022; 13:828410. [PMID: 35295778 PMCID: PMC8918631 DOI: 10.3389/fpsyt.2022.828410] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Accepted: 02/03/2022] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Technological developments such as Virtual reality (VR) provide new opportunities to extend and innovate mental healthcare. VR as a tool for clinical assessment has been described as promising, as it can enable real-time assessment within real-like environments or contexts as opposed to self-report and behavioral tasks in laboratory settings. OBJECTIVE With this systematic review we aimed to provide an overview of recent studies using VR in the assessment of psychiatric disorders. METHODS A systematic search was performed using Pubmed, Embase, PsycInfo, and Web of Science between 2016 and 2020. Studies were included if they used immersive VR, concerned assessment of psychiatric symptoms/disorders, and included adult patients with psychiatric disorders. RESULTS The search resulted in 3,163 potentially eligible articles, from which a total of 27 studies fulfilled inclusion criteria. Most studies considered anxiety (n = 7), addictive, (n = 7), or psychotic disorders (n = 5). Regarding ADHD (n = 3), PTSD (n = 3), and pedophilic disorder (n = 1), a few studies had been performed since 2016. The majority of the included studies compared patient groups to healthy control groups. DISCUSSION Recent studies on VR-assisted psychiatric assessments have been conducted to validate VR environments, to assess symptoms for diagnostics or therapy goals, search for biomarkers, and to gain knowledge on psychiatric disorders. VR tasks were able to detect some difference between patient and healthy control groups, mainly with regard to self-report measures. Despite previous, promising prospects, the use of VR as a tool in clinical assessments must still be considered as a field in need of continued developments and evaluations. SYSTEMATIC REVIEW REGISTRATION www.crd.york.ac.uk/prospero, identifier: CRD42021233772.
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Affiliation(s)
- Chris N W Geraets
- Lund Clinical Research on Externalizing and Developmental Psychopathology, Child and Adolescent Psychiatry, Department of Clinical Sciences Lund, Lund University, Lund, Sweden.,Research and Development Unit, Regional Forensic Psychiatric Clinic, Växjö, Sweden.,Department of Psychiatry, University Medical Center Groningen, Groningen, Netherlands
| | - Märta Wallinius
- Lund Clinical Research on Externalizing and Developmental Psychopathology, Child and Adolescent Psychiatry, Department of Clinical Sciences Lund, Lund University, Lund, Sweden.,Research and Development Unit, Regional Forensic Psychiatric Clinic, Växjö, Sweden.,Department of Psychiatry and Neurochemistry, Centre for Ethics, Law and Mental Health, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Kristina Sygel
- Research and Development Unit, Regional Forensic Psychiatric Clinic, Växjö, Sweden.,Department of Psychiatry and Neurochemistry, Centre for Ethics, Law and Mental Health, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden.,Department of Forensic Psychiatry, National Board of Forensic Medicine, Stockholm, Sweden
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8
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Virtual reality: a powerful technology to provide novel insight into treatment mechanisms of addiction. Transl Psychiatry 2021; 11:617. [PMID: 34873146 PMCID: PMC8648903 DOI: 10.1038/s41398-021-01739-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 10/20/2021] [Accepted: 11/01/2021] [Indexed: 12/31/2022] Open
Abstract
Due to its high ecological validity, virtual reality (VR) technology has emerged as a powerful tool for mental health research. Despite the wide use of VR simulations in research on mental illnesses, the study of addictive processes through the use of VR environments is still at its dawn. In a systematic literature search, we identified 38 reports of research projects using highly immersive head-mounted displays, goggles, or CAVE technologies to provide insight into treatment mechanisms of addictive behaviors. So far, VR research has mainly addressed the roles of craving, psychophysiology, affective states, cognition, and brain activity in addiction. The computer-generated VR environments offer very realistic, dynamic, interactive, and complex real-life simulations requesting active participation. They create a high sense of immersion in users by combining stereoscopic three-dimensional visual, auditory, olfactory, and tactile perceptions, tracking systems responding to user movements, and social interactions. VR is an emerging tool to study how proximal multi-sensorial cues, contextual environmental cues, as well as their interaction (complex cues) modulate addictive behaviors. VR allows for experimental designs under highly standardized, strictly controlled, predictable, and repeatable conditions. Moreover, VR simulations can be personalized. They are currently refined for psychotherapeutic interventions. Embodiment, eye-tracking, and neurobiological factors represent novel future directions. The progress of VR applications has bred auspicious ways to advance the understanding of treatment mechanisms underlying addictions, which researchers have only recently begun to exploit. VR methods promise to yield significant achievements to the addiction field. These are necessary to develop more efficacious and efficient preventive and therapeutic strategies.
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9
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Ha J, Park S, Im CH, Kim L. Classification of Gamers Using Multiple Physiological Signals: Distinguishing Features of Internet Gaming Disorder. Front Psychol 2021; 12:714333. [PMID: 34630223 PMCID: PMC8498337 DOI: 10.3389/fpsyg.2021.714333] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Accepted: 08/26/2021] [Indexed: 11/13/2022] Open
Abstract
The proliferating and excessive use of internet games has caused various comorbid diseases, such as game addiction, which is now a major social problem. Recently, the American Psychiatry Association classified “Internet gaming disorder (IGD)” as an addiction/mental disorder. Although many studies have been conducted on the diagnosis, treatment, and prevention of IGD, screening studies for IGD are still scarce. In this study, we classified gamers using multiple physiological signals to contribute to the treatment and prevention of IGD. Participating gamers were divided into three groups based on Young’s Internet Addiction Test score and average game time as follows: Group A, those who rarely play games; Group B, those who enjoy and play games regularly; and Group C, those classified as having IGD. In our game-related cue-based experiment, we obtained self-reported craving scores and multiple physiological data such as electrooculogram (EOG), photoplethysmogram (PPG), and electroencephalogram (EEG) from the users while they watched neutral (natural scenery) or stimulating (gameplay) videos. By analysis of covariance (ANCOVA), 13 physiological features (vertical saccadic movement from EOG, standard deviation of N-N intervals, and PNN50 from PPG, and many EEG spectral power indicators) were determined to be significant to classify the three groups. The classification was performed using a 2-layers feedforward neural network. The fusion of three physiological signals showed the best result compared to other cases (combination of EOG and PPG or EEG only). The accuracy was 0.90 and F-1 scores were 0.93 (Group A), 0.89 (Group B), and 0.88 (Group C). However, the subjective self-reported scores did not show a significant difference among the three groups by ANCOVA analysis. The results indicate that the fusion of physiological signals can be an effective method to objectively classify gamers.
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Affiliation(s)
- Jihyeon Ha
- Center for Bionics, Korea Institute of Science and Technology, Seoul, South Korea.,Department of Biomedical Engineering, Hanyang University, Seoul, South Korea
| | - Sangin Park
- Center for Bionics, Korea Institute of Science and Technology, Seoul, South Korea
| | - Chang-Hwan Im
- Department of Biomedical Engineering, Hanyang University, Seoul, South Korea
| | - Laehyun Kim
- Center for Bionics, Korea Institute of Science and Technology, Seoul, South Korea.,Department of HY-KIST Bio-Convergence, Hanyang University, Seoul, South Korea
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Langener S, Van Der Nagel J, van Manen J, Markus W, Dijkstra B, De Fuentes-Merillas L, Klaassen R, Heitmann J, Heylen D, Schellekens A. Clinical Relevance of Immersive Virtual Reality in the Assessment and Treatment of Addictive Disorders: A Systematic Review and Future Perspective. J Clin Med 2021; 10:3658. [PMID: 34441953 PMCID: PMC8396890 DOI: 10.3390/jcm10163658] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 08/10/2021] [Accepted: 08/14/2021] [Indexed: 02/02/2023] Open
Abstract
(1) Background: Virtual reality (VR) has been investigated in a variety of psychiatric disorders, including addictive disorders (ADs); (2) Objective: This systematic review evaluates the current evidence of immersive VR (using head-mounted displays) in the clinical assessment and treatment of ADs; (3) Method: PubMed and PsycINFO were queried for publications up to November 2020; (4) Results: We screened 4519 titles, 114 abstracts and 85 full-texts, and analyzed 36 articles regarding the clinical assessment (i.e., diagnostic and prognostic value; n = 19) and treatment (i.e., interventions; n = 17) of ADs. Though most VR assessment studies (n = 15/19) showed associations between VR-induced cue-reactivity and clinical parameters, only two studies specified diagnostic value. VR treatment studies based on exposure therapy showed no or negative effects. However, other VR interventions like embodied and aversive learning paradigms demonstrated positive findings. The overall study quality was rather poor; (5) Conclusion: Though VR in ADs provides ecologically valid environments to induce cue-reactivity and provide new treatment paradigms, the added clinical value in assessment and therapy remains to be elucidated before VR can be applied in clinical care. Therefore, future work should investigate VR efficacy in randomized clinical trials using well-defined clinical endpoints.
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Affiliation(s)
- Simon Langener
- Human Media Interaction, University of Twente, 7522 NB Enschede, The Netherlands; (J.V.D.N.); (R.K.); (D.H.)
- Tactus Addiction Centre, 7418 ET Deventer, The Netherlands;
- Nijmegen Institute for Scientist-Practitioners in Addiction, 6525 GD Nijmegen, The Netherlands; (W.M.); (B.D.); (L.D.F.-M.); (J.H.); (A.S.)
| | - Joanne Van Der Nagel
- Human Media Interaction, University of Twente, 7522 NB Enschede, The Netherlands; (J.V.D.N.); (R.K.); (D.H.)
- Tactus Addiction Centre, 7418 ET Deventer, The Netherlands;
- Nijmegen Institute for Scientist-Practitioners in Addiction, 6525 GD Nijmegen, The Netherlands; (W.M.); (B.D.); (L.D.F.-M.); (J.H.); (A.S.)
| | - Jeannette van Manen
- Tactus Addiction Centre, 7418 ET Deventer, The Netherlands;
- Nijmegen Institute for Scientist-Practitioners in Addiction, 6525 GD Nijmegen, The Netherlands; (W.M.); (B.D.); (L.D.F.-M.); (J.H.); (A.S.)
| | - Wiebren Markus
- Nijmegen Institute for Scientist-Practitioners in Addiction, 6525 GD Nijmegen, The Netherlands; (W.M.); (B.D.); (L.D.F.-M.); (J.H.); (A.S.)
- IrisZorg Addiction Care, 6835 HZ Arnhem, The Netherlands
| | - Boukje Dijkstra
- Nijmegen Institute for Scientist-Practitioners in Addiction, 6525 GD Nijmegen, The Netherlands; (W.M.); (B.D.); (L.D.F.-M.); (J.H.); (A.S.)
- Radboud University Medical Centre, 6525 GC Nijmegen, The Netherlands
- Novadic-Kentron, Network for Addiction Treatment Service, 5261 LX Vught, The Netherlands
| | - Laura De Fuentes-Merillas
- Nijmegen Institute for Scientist-Practitioners in Addiction, 6525 GD Nijmegen, The Netherlands; (W.M.); (B.D.); (L.D.F.-M.); (J.H.); (A.S.)
- Novadic-Kentron, Network for Addiction Treatment Service, 5261 LX Vught, The Netherlands
| | - Randy Klaassen
- Human Media Interaction, University of Twente, 7522 NB Enschede, The Netherlands; (J.V.D.N.); (R.K.); (D.H.)
| | - Janika Heitmann
- Nijmegen Institute for Scientist-Practitioners in Addiction, 6525 GD Nijmegen, The Netherlands; (W.M.); (B.D.); (L.D.F.-M.); (J.H.); (A.S.)
- Department of Clinical Psychology and Experimental Psychopathology, University of Groningen, 9712 CP Groningen, The Netherlands
| | - Dirk Heylen
- Human Media Interaction, University of Twente, 7522 NB Enschede, The Netherlands; (J.V.D.N.); (R.K.); (D.H.)
| | - Arnt Schellekens
- Nijmegen Institute for Scientist-Practitioners in Addiction, 6525 GD Nijmegen, The Netherlands; (W.M.); (B.D.); (L.D.F.-M.); (J.H.); (A.S.)
- Radboud University Medical Centre, 6525 GC Nijmegen, The Netherlands
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11
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Hernández-Serrano O, Ghiţă A, Fernández-Ruiz J, Monràs M, Gual A, Gacto M, Porras-García B, Ferrer-García M, Gutiérrez-Maldonado J. Determinants of Cue-Elicited Alcohol Craving and Perceived Realism in Virtual Reality Environments among Patients with Alcohol Use Disorder. J Clin Med 2021; 10:2241. [PMID: 34064120 PMCID: PMC8196721 DOI: 10.3390/jcm10112241] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 05/17/2021] [Accepted: 05/19/2021] [Indexed: 12/31/2022] Open
Abstract
The identification of variables that can modulate the efficacy of cue exposure using virtual reality (VR) is crucial. This study aimed to explore determinant variables of cue-elicited alcohol craving and perceived realism (PR) of environments and alcoholic beverages during a VR cue-exposure session among alcohol use disorder (AUD) outpatients. A prospective cohort study was conducted amongst 72 outpatients with AUD from a clinical setting. Alcohol craving experienced during VR exposure and PR of virtual environments and alcoholic drinks were evaluated after a VR session of exposure to alcohol-related contexts and cues. Sociodemographic, psychological and consumption characteristics were examined as possible predicting variables. Multiple linear regression analyses showed that the AUD severity and PR of beverages were predictors of cue-elicited alcohol craving. Educational level, PR of beverages and age were predictors of the PR of VR environments. In relation to the PR of VR beverages, cue-elicited alcohol craving and the PR of environments were predictors. A simple mediational model was also performed to analyze the influence of the PR of beverages on the relationship between the AUD severity and alcohol craving experienced during VR exposure: an indirect or mediational effect was found. PR of alcoholic beverages was (1) a key predictor of the PR of VR environments (and vice versa) and the alcohol craving (and vice versa) experienced during VR cue-exposure sessions using ALCO-VR software among AUD patients and (2) a mediator between AUD severity and cue-elicited alcohol craving.
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Affiliation(s)
- Olga Hernández-Serrano
- Department of Psychology, Catholic University of Saint Anthony, Av. de los Jerónimos, 135, Guadalupe de Maciascoque, 30107 Murcia, Spain;
| | - Alexandra Ghiţă
- Department of Psychology, Health and Technology, University of Twente, Drienerlolaan, 5, 7522 NB Enschede, The Netherlands;
| | - Jolanda Fernández-Ruiz
- Department of Clinical Psychology and Psychobiology, Faculty of Psychology, University of Barcelona, Passeig de Vall d’Hebron 175, 08035 Barcelona, Spain; (J.F.-R.); (B.P.-G.); (M.F.-G.)
| | - Miquel Monràs
- Addictive Behaviors Unit, Hospital Clinic of Barcelona, Carrer de Villarroel, 170, 08036 Barcelona, Spain; (M.M.); (A.G.)
| | - Antoni Gual
- Addictive Behaviors Unit, Hospital Clinic of Barcelona, Carrer de Villarroel, 170, 08036 Barcelona, Spain; (M.M.); (A.G.)
| | - Mariano Gacto
- Department of Physical Therapy, Faculty of Medicine, Campus Espinardo, University of Murcia, 30100 Murcia, Spain;
| | - Bruno Porras-García
- Department of Clinical Psychology and Psychobiology, Faculty of Psychology, University of Barcelona, Passeig de Vall d’Hebron 175, 08035 Barcelona, Spain; (J.F.-R.); (B.P.-G.); (M.F.-G.)
| | - Marta Ferrer-García
- Department of Clinical Psychology and Psychobiology, Faculty of Psychology, University of Barcelona, Passeig de Vall d’Hebron 175, 08035 Barcelona, Spain; (J.F.-R.); (B.P.-G.); (M.F.-G.)
| | - José Gutiérrez-Maldonado
- Department of Clinical Psychology and Psychobiology, Faculty of Psychology, University of Barcelona, Passeig de Vall d’Hebron 175, 08035 Barcelona, Spain; (J.F.-R.); (B.P.-G.); (M.F.-G.)
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12
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Reliability assessment of temporal discounting measures in virtual reality environments. Sci Rep 2021; 11:7015. [PMID: 33782424 PMCID: PMC8007609 DOI: 10.1038/s41598-021-86388-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Accepted: 03/15/2021] [Indexed: 02/01/2023] Open
Abstract
In recent years the emergence of high-performance virtual reality (VR) technology has opened up new possibilities for the examination of context effects in psychological studies. The opportunity to create ecologically valid stimulation in a highly controlled lab environment is especially relevant for studies of psychiatric disorders, where it can be problematic to confront participants with certain stimuli in real life. However, before VR can be confidently applied widely it is important to establish that commonly used behavioral tasks generate reliable data within a VR surrounding. One field of research that could benefit greatly from VR-applications are studies assessing the reactivity to addiction related cues (cue-reactivity) in participants suffering from gambling disorder. Here we tested the reliability of a commonly used temporal discounting task in a novel VR set-up designed for the concurrent assessment of behavioral and psychophysiological cue-reactivity in gambling disorder. On 2 days, thirty-four healthy non-gambling participants explored two rich and navigable VR-environments (neutral: café vs. gambling-related: casino and sports-betting facility), while their electrodermal activity was measured using remote sensors. In addition, participants completed the temporal discounting task implemented in each VR environment. On a third day, participants performed the task in a standard lab testing context. We then used comprehensive computational modeling using both standard softmax and drift diffusion model (DDM) choice rules to assess the reliability of discounting model parameters assessed in VR. Test-retest reliability estimates were good to excellent for the discount rate log(k), whereas they were poor to moderate for additional DDM parameters. Differences in model parameters between standard lab testing and VR, reflecting reactivity to the different environments, were mostly numerically small and of inconclusive directionality. Finally, while exposure to VR generally increased tonic skin conductance, this effect was not modulated by the neutral versus gambling-related VR-environment. Taken together this proof-of-concept study in non-gambling participants demonstrates that temporal discounting measures obtained in VR are reliable, suggesting that VR is a promising tool for applications in computational psychiatry, including studies on cue-reactivity in addiction.
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Ghiţă A, Hernández-Serrano O, Fernández-Ruiz J, Moreno M, Monras M, Ortega L, Mondon S, Teixidor L, Gual A, Gacto-Sanchez M, Porras-García B, Ferrer-García M, Gutiérrez-Maldonado J. Attentional Bias, Alcohol Craving, and Anxiety Implications of the Virtual Reality Cue-Exposure Therapy in Severe Alcohol Use Disorder: A Case Report. Front Psychol 2021; 12:543586. [PMID: 33692713 PMCID: PMC7937649 DOI: 10.3389/fpsyg.2021.543586] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Accepted: 01/13/2021] [Indexed: 12/04/2022] Open
Abstract
Aims: Attentional bias (AB), alcohol craving, and anxiety have important implications in the development and maintenance of alcohol use disorder (AUD). The current study aims to test the effectiveness of a Virtual Reality Cue-Exposure Therapy (VR-CET) to reduce levels of alcohol craving and anxiety and prompt changes in AB toward alcohol content. Method: A 49-year-old male participated in this study, diagnosed with severe AUD, who also used tobacco and illicit substances on an occasional basis and who made several failed attempts to cease substance misuse. The protocol consisted of six VR-CET booster sessions and two assessment sessions (pre- and post-VR-CET) over the course of 5 weeks. The VR-CET program consisted of booster therapy sessions based on virtual reality (VR) exposure to preferred alcohol-related cues and contexts. The initial and final assessment sessions were focused on exploring AB, alcohol craving, and anxiety using paper-and-pencil instruments and the eye-tracking (ET) and VR technologies at different time points. Results: Pre and post assessment sessions indicated falls on the scores of all instruments assessing alcohol craving, anxiety, and AB. Conclusions: This case report, part of a larger project, demonstrates the effectiveness of the VR-CET booster sessions in AUD. In the post-treatment measurements, a variety of instruments showed a change in the AB pattern and an improvement in craving and anxiety responses. As a result of the systematic desensitization, virtual exposure gradually reduced the responses to significant alcohol-related cues and contexts. The implications for AB, anxiety and craving are discussed.
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Affiliation(s)
- Alexandra Ghiţă
- Department of Clinical Psychology and Psychobiology, University of Barcelona, Barcelona, Spain
| | | | - Jolanda Fernández-Ruiz
- Department of Clinical Psychology and Psychobiology, University of Barcelona, Barcelona, Spain
| | - Manuel Moreno
- Department of Cognition, Development and Educational Psychology, University of Barcelona, Barcelona, Spain
| | - Miquel Monras
- Addictive Behaviors Unit, Hospital Clinic of Barcelona, Barcelona, Spain
| | - Lluisa Ortega
- Addictive Behaviors Unit, Hospital Clinic of Barcelona, Barcelona, Spain
| | - Silvia Mondon
- Addictive Behaviors Unit, Hospital Clinic of Barcelona, Barcelona, Spain
| | - Lidia Teixidor
- Addictive Behaviors Unit, Hospital Clinic of Barcelona, Barcelona, Spain
| | - Antoni Gual
- Addictive Behaviors Unit, Hospital Clinic of Barcelona, Barcelona, Spain
| | | | - Bruno Porras-García
- Department of Clinical Psychology and Psychobiology, University of Barcelona, Barcelona, Spain
| | - Marta Ferrer-García
- Department of Clinical Psychology and Psychobiology, University of Barcelona, Barcelona, Spain
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14
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Gómez-Busto FJ, Ortiz MI. Virtual Reality and Psychedelics for the Treatment of Psychiatric Disease: A Systematic Literature Review. CLINICAL NEUROPSYCHIATRY 2020; 17:365-380. [PMID: 34909015 PMCID: PMC8629068 DOI: 10.36131/cnfioritieditore20200606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Hallucinogenic substances or psychedelic drugs have been historically used by humans worldwide for centuries, and interest grows around them because of the therapeutic potential that they pose for mental disease. Virtual Reality (VR), has been highly developed and improved in the last decade, and it is also gaining importance due to their potential as therapeutic tools. In this article, the most recent and relevant information regarding the medical applications of both VR and psychedelics was highlighted, and diverse potential therapeutic uses were explored in hope to set the ground for further research on this topic. METHOD A systematic literature review using the PRISMA methods was conducted in PubMed, Medline, Embase, Cochrane Library, Scopus and Web of Science, including only peer-reviewed clinical trials or case studies written in English, that address the use of psychedelics and/or VR for the treatment of psychiatric disorders and that measure the success of the therapies. A final selection of 23 manuscripts were used in this systematic review. RESULTS VR showed security and significant efficacy in the management of special cases of phobias (social, motion pain and spiders), eating disorder, post-traumatic stress disorder (PTSD), gambling disorder, preoperative anxiety and schizophrenia. CONCLUSIONS The hallucinogenic drugs evaluated exhibited positive effects in treatment of depressive and anxiety disorders, alcohol dependence and PTSD. More research is needed in order to test the effectiveness of these therapies (alone or together) in different mental illnesses and different populations.
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Affiliation(s)
- Federico J. Gómez-Busto
- Department of Pharmacology, Academic Area of Medicine, Institute of Health Sciences, Universidad Autónoma del Estado de Hidalgo, Pachuca, Hidalgo, Mexico., Eliseo Ramírez Ulloa 400, Col. Doctores, 42090, Pachuca, Hidalgo, MEXICO
| | - Mario I. Ortiz
- Department of Pharmacology, Academic Area of Medicine, Institute of Health Sciences, Universidad Autónoma del Estado de Hidalgo, Pachuca, Hidalgo, Mexico., Eliseo Ramírez Ulloa 400, Col. Doctores, 42090, Pachuca, Hidalgo, MEXICO,Corresponding author Mario I. Ortiz, Ph.D. Department of Pharmacology, Academic Area of Medicine, Institute of Health Sciences Universidad Autónoma del Estado de Hidalgo Eliseo Ramírez Ulloa 400, Col. Doctores Pachuca, Hgo. - 42090, MEXICO Phone: +52-77-1717-2000 Ext. 2361 E-mail:
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15
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Hernández-Serrano O, Ghiţă A, Figueras-Puigderrajols N, Fernández-Ruiz J, Monras M, Ortega L, Mondon S, Teixidor L, Gual A, Ugas-Ballester L, Fernández M, Montserrat R, Porras-Garcia B, Ferrer-Garcia M, Gutiérrez-Maldonado J. Predictors of Changes in Alcohol Craving Levels during a Virtual Reality Cue Exposure Treatment among Patients with Alcohol Use Disorder. J Clin Med 2020; 9:E3018. [PMID: 32962176 PMCID: PMC7565669 DOI: 10.3390/jcm9093018] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2020] [Revised: 09/12/2020] [Accepted: 09/17/2020] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND/OBJECTIVE Determining the predictive variables associated with levels of alcohol craving can ease the identification of patients who can benefit from treatments. This study aimed to describe changes (improvement or no change/deterioration) in alcohol craving levels and explore the predictors of these changes from admission to discharge in outpatients with alcohol use disorder (AUD) undergoing treatment-as-usual (TAU), or treatment-as-usual supplemented with virtual reality cue-exposure therapy (TAU + VR-CET). METHOD A prospective cohort study was conducted amongst 42 outpatients with AUD (n = 15 TAU + VR-CET and n = 27 TAU) from a clinical setting. Changes in the levels of alcohol craving between admission and discharge were assessed with the Multidimensional Alcohol Craving Scale. Sociodemographic characteristics (age, gender, education, and socioeconomic and civil status), cognitive-affective behavioral patterns (AUD severity, abstinence duration, psychiatric comorbidity, state anxiety, attentional bias, and substance use), and type of treatment (TAU + VR-CET and only TAU) were also evaluated. RESULTS The TAU + VR-CET group showed greater changes of improvement in the levels of alcohol craving than the TAU group (χ2 = 10.996; p = 0.001). Intragroup changes in alcohol craving from pre to post-treatment were significant in the TAU + VR-CET group (χ2 = 13.818; p = 0.003) but not within the TAU group (χ2 = 2.349; p = 0.503). The odds of an improvement in any of the craving levels between pre- and post-test was 18.18 (1/0.055) times higher in the TAU + VR-CET group with respect to the TAU group. The use of illicit drugs in the month prior to the test increased the odds of having a positive change by 18.18 (1/0.055) with respect to not having consumed. CONCLUSIONS Including VR-CET in TAU programs may provide benefits in the treatment of AUDs mainly among patients with intense alcohol craving and individuals having used illicit substances prior to treatment.
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Affiliation(s)
- Olga Hernández-Serrano
- Department of Physical Therapy, Escola Universitària de la Salut i l’Esport (EUSES)-University of Girona, Carrer Francesc Macià, 65, Campus of Salt, 17190 Girona PC, Spain;
| | - Alexandra Ghiţă
- Department of Clinical Psychology and Psychobiology, Faculty of Psychology, University of Barcelona, Passeig de Vall d’Hebron, 175, 08035 Barcelona PC, Spain; (A.G.); (N.F.-P.); (J.F.-R.); (L.U.-B.); (M.F.); (R.M.); (B.P.-G.); (M.F.-G.)
| | - Natàlia Figueras-Puigderrajols
- Department of Clinical Psychology and Psychobiology, Faculty of Psychology, University of Barcelona, Passeig de Vall d’Hebron, 175, 08035 Barcelona PC, Spain; (A.G.); (N.F.-P.); (J.F.-R.); (L.U.-B.); (M.F.); (R.M.); (B.P.-G.); (M.F.-G.)
| | - Jolanda Fernández-Ruiz
- Department of Clinical Psychology and Psychobiology, Faculty of Psychology, University of Barcelona, Passeig de Vall d’Hebron, 175, 08035 Barcelona PC, Spain; (A.G.); (N.F.-P.); (J.F.-R.); (L.U.-B.); (M.F.); (R.M.); (B.P.-G.); (M.F.-G.)
| | - Miquel Monras
- Addictive Behaviors Unit, Hospital Clinic of Barcelona, Carrer de Villarroel, 170, 08036 Barcelona PC, Spain; (M.M.); (L.O.); (S.M.); (L.T.); (A.G.)
| | - Lluïsa Ortega
- Addictive Behaviors Unit, Hospital Clinic of Barcelona, Carrer de Villarroel, 170, 08036 Barcelona PC, Spain; (M.M.); (L.O.); (S.M.); (L.T.); (A.G.)
| | - Silvia Mondon
- Addictive Behaviors Unit, Hospital Clinic of Barcelona, Carrer de Villarroel, 170, 08036 Barcelona PC, Spain; (M.M.); (L.O.); (S.M.); (L.T.); (A.G.)
| | - Lidia Teixidor
- Addictive Behaviors Unit, Hospital Clinic of Barcelona, Carrer de Villarroel, 170, 08036 Barcelona PC, Spain; (M.M.); (L.O.); (S.M.); (L.T.); (A.G.)
| | - Antoni Gual
- Addictive Behaviors Unit, Hospital Clinic of Barcelona, Carrer de Villarroel, 170, 08036 Barcelona PC, Spain; (M.M.); (L.O.); (S.M.); (L.T.); (A.G.)
| | - Lidia Ugas-Ballester
- Department of Clinical Psychology and Psychobiology, Faculty of Psychology, University of Barcelona, Passeig de Vall d’Hebron, 175, 08035 Barcelona PC, Spain; (A.G.); (N.F.-P.); (J.F.-R.); (L.U.-B.); (M.F.); (R.M.); (B.P.-G.); (M.F.-G.)
| | - Maribel Fernández
- Department of Clinical Psychology and Psychobiology, Faculty of Psychology, University of Barcelona, Passeig de Vall d’Hebron, 175, 08035 Barcelona PC, Spain; (A.G.); (N.F.-P.); (J.F.-R.); (L.U.-B.); (M.F.); (R.M.); (B.P.-G.); (M.F.-G.)
| | - Roger Montserrat
- Department of Clinical Psychology and Psychobiology, Faculty of Psychology, University of Barcelona, Passeig de Vall d’Hebron, 175, 08035 Barcelona PC, Spain; (A.G.); (N.F.-P.); (J.F.-R.); (L.U.-B.); (M.F.); (R.M.); (B.P.-G.); (M.F.-G.)
| | - Bruno Porras-Garcia
- Department of Clinical Psychology and Psychobiology, Faculty of Psychology, University of Barcelona, Passeig de Vall d’Hebron, 175, 08035 Barcelona PC, Spain; (A.G.); (N.F.-P.); (J.F.-R.); (L.U.-B.); (M.F.); (R.M.); (B.P.-G.); (M.F.-G.)
| | - Marta Ferrer-Garcia
- Department of Clinical Psychology and Psychobiology, Faculty of Psychology, University of Barcelona, Passeig de Vall d’Hebron, 175, 08035 Barcelona PC, Spain; (A.G.); (N.F.-P.); (J.F.-R.); (L.U.-B.); (M.F.); (R.M.); (B.P.-G.); (M.F.-G.)
| | - José Gutiérrez-Maldonado
- Department of Clinical Psychology and Psychobiology, Faculty of Psychology, University of Barcelona, Passeig de Vall d’Hebron, 175, 08035 Barcelona PC, Spain; (A.G.); (N.F.-P.); (J.F.-R.); (L.U.-B.); (M.F.); (R.M.); (B.P.-G.); (M.F.-G.)
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Sainz-Fuertes R, Gelabert Mir JM, Valderas JM, Bullock K, Giersch A, Vogeley K, García AT, Huguet MA, Russell T, Hollingdale J, Lopez-Moriñigo JD, Delgado IN, Selsick H, Gurr H, Fitzpatrick T, Maddox T. COVID-19 and mental health: A review and the role of telehealth and virtual reality. DIGITAL MEDICINE 2020; 6:53-66. [PMID: 35663234 PMCID: PMC9148628 DOI: 10.4103/digm.digm_22_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 09/21/2020] [Accepted: 11/26/2020] [Indexed: 01/10/2023]
Abstract
On March 12, 2020, with more than 20,000 confirmed cases and almost 1000 deaths in the European Region, the World Health Organization classified the COVID-19 outbreak as a pandemic. As of August 15, 2020, there are 21.5 million confirmed cases of COVID-19 and over 766,000 deaths from the virus, worldwide. Most governments have imposed quarantine measures of varied degrees of strictness on their populations in attempts to stall the spread of the infection in their communities. However, the isolation may have inflicted long-term psychological injury to the general population and, in particular, to at-risk groups such as the elderly, the mentally ill, children, and frontline healthcare staff. In this article, we offer the most up-to-date review of the effects of COVID-19 confinement on all the disorders listed in the Diagnostic and Statistical Manual of Mental Disorders. We make data-driven predictions of the impact of COVID-19 confinement on mental health outcomes and discuss the potential role of telemedicine and virtual reality in mental health screening, diagnosis, treatment, and monitoring, thus improving the above outcomes in such a difficult time
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Affiliation(s)
| | | | | | - Kim Bullock
- Department of Psychiatry and Behavioral Sciences, Stanford School of Medicine, USA
| | - Anne Giersch
- University of Strasbourg, INSERM, University Hospital of Strasbourg, France
| | - Kai Vogeley
- Department of Psychiatry, University Hospital Cologne, Germany
| | | | | | - Tamara Russell
- Mindfulness Centre of Excellence, The Maudsley Hospital, London, UK
| | | | | | | | - Hugh Selsick
- Royal London Hospital for Integrated Medicine, London, UK
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