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Region Hovedstaden - en del af Københavns Universitetshospital

CHALLENGE. A randomised clinical trial examining virtual reality avatar therapy for persistent auditory hallucinations versus treatment as usual in people with psychosis

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Objectives: Auditory hallucinations are among the most frequent symptoms in psychotic disorders. While a large group of patients with first episode psychosis achieve remission of psychotic symptoms during first year after initial contact with mental health services, almost one third continue having psychotic symptoms in spite of treatment with antipsychotic medication. Since auditory hallucinations are a major cause of distress and suffering for these patients, there is an essential need to search for new ways of alleviating auditory hallucinations

Aims: The aim of this trial is to examine the effect of a targeted virtual reality therapy, termed avatar therapy, for persistent auditory hallucinations in individuals with psychosis. We want to explore whether avatar therapy can decrease the severity, frequency and distress of auditory hallucinations and additionally, if the avatar therapy can reduce clinical symptoms and enhance daily functioning in individuals with psychosis.

Method: The study is a randomised, assessor-blinded parallel-groups superiority clinical trial, allocating a total of 266 patients to either the experimental intervention or standard intervention. The participants will be randomised to either 12-weeks of avatar therapy or treatment as usual. All participants will be assessed at baseline and 12- and 24 weeks post baseline. A stratified block-randomisation with concealed randomisation sequence will be conducted. Independent assessors blinded to the treatment will evaluate outcome. Analysis of outcome will be carried out with the intention to treat principles.

Conclusion: If the virtual reality avatar therapy is found to be beneficial in reducing the severity of refractory auditory hallucinations, it will be a breakthrough in the current treatment of psychotic disorders. A large group of patients with schizophrenia and related disorders in Denmark and worldwide will be the target group of the therapy. If proven effective, the treatment will be especially relevant for patients with treatment resistant schizophrenia, but the treatment can also be used as an add on to antipsychotic medication for patients with a better prognosis, such as patients with first episode psychosis. If proven effective, the avatar therapy can be implemented in mental health services all over Denmark and internationally. A successful implementation will then substantially reduce the costs associated with treatment of schizophrenia.


  • Sundhedsvidenskab - Schizophrenia Spectrum and Other Psychotic Disorders, psychotherapy, Randomized Controlled Clinical Trial

ID: 61868176