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Virtual reality exposure therapy for social anxiety disorder: a systematic review and meta-analysis

Published online by Cambridge University Press:  19 October 2020

Toshiro Horigome ,
Shunya Kurokawa ,
Kyosuke Sawada ,
Shun Kudo ,
Kiko Shiga ,
Masaru Mimura  and
Taishiro Kishimoto Open the ORCID record for Taishiro Kishimoto [Opens in a new window]
Toshiro Horigome*
Affiliation:
Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
Shunya Kurokawa
Affiliation:
Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
Kyosuke Sawada
Affiliation:
Asaka Hospital, Fukushima, Japan
Shun Kudo
Affiliation:
Department of Neuropsychiatry, Japanese Red Cross Ashikaga Hospital, Tochigi, Japan
Kiko Shiga
Affiliation:
Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
Masaru Mimura
Affiliation:
Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
Taishiro Kishimoto
Affiliation:
Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan Psychiatry at Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, New York, New York, USA
*
Author for correspondence: Taishiro Kishimoto, E-mail: taishiro-k@mti.biglobe.ne.jp
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Abstract

Background

Virtual reality exposure therapy (VRET) is currently being used to treat social anxiety disorder (SAD); however, VRET's magnitude of efficacy, duration of efficacy, and impact on treatment discontinuation are still unclear.

Methods

We conducted a meta-analysis of studies that investigated the efficacy of VRET for SAD. The search strategy and analysis method are registered at PROSPERO (#CRD42019121097). Inclusion criteria were: (1) studies that targeted patients with SAD or related phobias; (2) studies where VRET was conducted for at least three sessions; (3) studies that included at least 10 participants. The primary outcome was social anxiety evaluation score change. Hedges' g and its 95% confidence intervals were calculated using random-effect models. The secondary outcome was the risk ratio for treatment discontinuation.

Results

Twenty-two studies (n = 703) met the inclusion criteria and were analyzed. The efficacy of VRET for SAD was significant and continued over a long-term follow-up period: Hedges' g for effect size at post-intervention, −0.86 (−1.04 to −0.68); three months post-intervention, −1.03 (−1.35 to −0.72); 6 months post-intervention, −1.14 (−1.39 to −0.89); and 12 months post-intervention, −0.74 (−1.05 to −0.43). When compared to in vivo exposure, the efficacy of VRET was similar at post-intervention but became inferior at later follow-up points. Participant dropout rates showed no significant difference compared to in vivo exposure.

Conclusion

VRET is an acceptable treatment for SAD patients that has significant, long-lasting efficacy, although it is possible that during long-term follow-up, VRET efficacy lessens as compared to in vivo exposure.

Keywords

Dropout ratein vivo exposurelong-term efficacysocial anxiety disordervirtual reality exposure
Type
Review Article
Information
Psychological Medicine , Volume 50 , Issue 15 , November 2020 , pp. 2487 - 2497
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Copyright
Copyright © The Author(s) 2020. Published by Cambridge University Press

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