[The possibilities of using virtual reality technology for managing auditory hallucinations in schizophrenia spectrum...

Introduction: Virtual reality-based therapies offer a promising approach for treating residual auditory verbal hallucinations, helping patients better understand and manage their hallucinations in a controlled and safe environment. Objective: This systematic literature review aims to summarize research findings from the past decade on this patient population. Method: A systematic literature review was conducted following the PRISMA guideline for the period between 2014 and December 31, 2024, using the PubMed and Web of Science databases. The search strategy included the following keywords: “virtual reality” OR “avatar therapy” AND “auditory verbal hallucination” OR “auditory hallucination” OR “acoustic hallucination” AND “schizophrenia” OR “psychosis”. Two independent reviewers screened the databases, involving additional authors in case of disagreements. Results: The review identified 188 original publications and an additional 83 records, of which 14 studies met the strict inclusion criteria. Among them, 13 studies examined AVATAR therapy, while one focused on virtual reality-based mindfulness techniques. AVATAR therapy showed positive effects in controlling hallucinations, reducing their frequency and intensity, and alleviating distress and negative beliefs. The virtual reality-based mindfulness technique also demonstrated symptom improvement in multiple areas but it was less effective than AVATAR therapy in reducing distress. Qualitative studies documented improvements in self-perception and self-acceptance. Conclusion: The findings support the potential of virtual reality-based therapies as effective adjunctive tools for treating patients with schizophrenia spectrum disorders. However, further research is needed to understand the long-term effects of these interventions. Orv Hetil. 2025; 166(19): 728–736.