BACKGROUND Mental disorders are a leading cause of global health-related burden. The disorders are expected to be the leading cause of morbidity among adults as the incidence rates of anxiety and depression grows globally. Recently, extended reality (XR), a general term covering virtual reality (VR), augmented reality (AR) and mixed reality (AR) has paved a new avenue to deliver care for mental disorders. This paper provides a systematic review about the development and application of XR for anxiety and depression amidst mental disorders. OBJECTIVE This systematic study is aimed to investigate the implementation level of different VR, AR, and MR techniques in the care of depression and anxiety. The objective of this study is to highlight the XR technologies that were used to deliver care for mental disorders, and to evaluate the effectiveness of using XR systems for anxiety and depression amidst other mental disorders. METHODS We performed a systematic review to identify relevant studies using three databases namely Google Scholar, PubMED, and Association for Computing Machinery Digital Library. A search period of May 2017 and August 2021 was defined to filter out articles related to the usage of VR, AR, and MR in a mental health context. Using two pre-defined search terms, a total of 679 articles were analyzed. Inclusion and exclusion criteria were applied to identify 72 relevant articles for further processing. RESULTS In this review we identified 72 studies from 23 countries across the globe, with the majority of studies being reported for developed countries such as USA (20.64%) and Germany (11.11%). Meanwhile, none of the studies observed was from an African country. The majority of the articles reported that XR techniques led to a significant reduction in symptoms of anxiety or depression. The majority of studies were published in the year 2021, i.e. 36.51% (n = 23) of the total studies included. In a sense, this data might be attributed to COVID-19 pandemic. Most studies (n = 30, 47.62%) focused a population with age range of 18 to 65 years, while fewer studies (n = 4, 6.35%) focused on each of adolescents (10 – 19 years) and seniors (> 64 years). Also, more studies were done experimentally (n = 52, 82.54 %) rather than by analytical and modeling approach (n = 5, 7.94% each) as found in other XR studies domain. Thus this could rapidly aid intervention of mental health disorder with XR. CONCLUSIONS In this systematic review we investigated the implementation of XR in the care of patients with anxiety and depression. The review covered 72 studies using different types of VR, AR, and MR techniques for managing anxiety and depression. Moreover, the studies adopted unique designs that are set up to record the effects of the mental health and formulating appropriate therapy for improvements. This review study could aid the development of XR systems for effective cognitive behavioral and exposure therapies of mental disorders. CLINICALTRIAL N/A

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