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Simultaneous Application of Transcranial Direct Current Stimulation during Virtual Reality Exposure

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Virtual Reality Behavioral Activation as an Intervention for Major Depressive Disorder: Case Report.

Margot Paul¹, Kim Bullock², Jeremy Bailenson³

¹PGSP-Stanford PsyD Consortium, Palo Alto, CA, United States.

JMIR Mental Health

|October 8, 2020

Summary

Virtual reality behavioral activation (VR BA) is a feasible and acceptable treatment for major depressive disorder (MDD). This VR BA intervention reduced depressive symptoms in an adult patient during the COVID-19 pandemic.

Keywords:

COVID-19 VR acceptability behavior behavioral activation case report depression feasibility intervention major depressive disorder pilot study telehealth virtual reality

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Area of Science:

Mental Health Technology
Digital Therapeutics
Psychiatry

Background:

Major Depressive Disorder (MDD) presents a growing global health challenge, exacerbated by the COVID-19 pandemic.
Behavioral activation (BA) is an effective MDD treatment, but pandemic-related restrictions impede patient engagement.
Virtual Reality (VR) offers a novel approach to deliver BA, overcoming current accessibility barriers.

Purpose of the Study:

To assess the feasibility, acceptability, and tolerability of a VR-based BA intervention for an adult with MDD.
To describe the VR intervention protocol within a larger pilot study context.
To evaluate the impact of VR BA on depressive symptoms during the COVID-19 pandemic.

Main Methods:

A 4-week pilot study involving weekly 50-minute VR psychotherapy sessions.
A modified BA protocol delivered via VR headset to simulate activities.
Data collection included mood ratings, homework compliance, headset usage, and self-reported acceptability and depression severity (PHQ-9).

Main Results:

The VR BA intervention demonstrated feasibility, acceptability, and tolerability.
The participant's depressive symptoms decreased by 5 points on the Patient Health Questionnaire-9 (PHQ-9) from 10 (moderate) to 5 (mild).
VR BA effectively reduced symptoms in an MDD patient during pandemic restrictions.

Conclusions:

VR BA is a promising therapeutic modality for MDD, particularly when in-person treatments are challenging.
Findings support further research into VR BA for clinical populations.
This case report highlights the potential of VR to enhance mental healthcare accessibility and efficacy.