Virtual Reality Rehabilitation’s Impact on Negative Symptoms and Psychosocial Rehabilitation in Schizophrenia Spectrum Disorder: A Systematic Review

Abstract

Background: Schizophrenia is a chronic psychiatric disorder with symptoms that can severely affect patients’ quality of life. While drug administration inhibits most of the positive symptoms, it fails to effectively treat the negative symptoms and in turn relies on rehabilitation therapies. With technological progress, virtual reality (VR) has been the target of recent studies in terms of mental health rehabilitation and has been shown to be a tool with ecological validity in order to introduce the individual to situations similar to their daily life. Methods: From July to August 2021, we conducted a systematic review with the purpose of understanding the impact of virtual reality rehabilitation on negative symptoms and psychosocial rehabilitation in the schizophrenia spectrum. The searches were performed in the databases Web of Science, Scopus, and PubMed. Results: In our search, we identified 201 results, where 108 duplicates were excluded, resulting in a final balance of 93. After reading and assessing the titles and abstracts, 66 studies were excluded. Of the remaining 27 reports, 23 were excluded for not meeting the previously defined eligibility criteria, resulting in the inclusion of four studies in this systematic review. Conclusions: The available data on the specific topic was limited and could have been more complete. However, in our review, we were able to identify statistically relevant results demonstrating the effectiveness of intervention. We could find medium to large effects, allowing VR to be an ally for rehabilitation of symptoms related to schizophrenia.

Self-Regulatory Neuronal Mechanisms and Long-Term Challenges in Schizophrenia Treatment

“…People diagnosed with schizophrenia may experience significant difficulties in social cognitive functioning, including problems with understanding actions, emotions, social perception, and/or empathy [ 113 ]. Some of the psychotic symptoms, i.e., hallucinations and delusions, are partially alleviated by antipsychotic drugs, but social impairments are a significant problem, complicating the path to health stability/recovery [ 114 ]. In general, the use of antipsychotic drugs has reduced effectiveness on the negative symptoms of schizophrenia.…”

“…These symptoms are associated with negative effects on the patient’s functional status and quality of life. The clinical expression of negative symptoms is less pronounced compared to positive symptoms, as they may be masked by positive symptoms and may coexist with or be confused with affective symptoms or cognitive disorders [ 114 , 115 ]. The above dysfunctions affect patients’ daily functioning.…”

Turning the Spotlight on Apathy: Identification and Treatment in Schizophrenia Spectrum Disorders

“… 53 In treatment, transcranial stimulation of the cerebellum may be in the pipeline. 54 Moreover, using virtual reality to simulate real-world goal-directed behaviors, 55 or smartphone-based ecological momentary interventions designed to increase reward sensitivity and motivation could potentially augment treatment effects. 56 It is imperative that future clinical and research efforts target apathy and its detrimental consequences.…”

Effects of Serious Games on Depression in Older Adults: Systematic Review and Meta-analysis of Randomized Controlled Trials

“…Serious games are considered appropriate interventions in mental health care, including for the general population and patients with or without psychiatric concerns [41][42][43]. Studies have reported that serious games influence depression [44,45]; however, a systematic review and meta-analysis focusing on the effect size of a serious game on depression in older adults is rare.…”