Efficacy of a blended, mobile-based intervention with integrated virtual reality exposure therapy for panic disorder...

Panic disorder (PD) and agoraphobia (AG) are prevalent mental health issues. Recent approaches have integrated mobile virtual reality exposure therapy (VRET) into internet- and mobile-based interventions (IMIs) to facilitate exposure therapy, providing a promising supplement to traditional psychotherapy. This preregistered, randomized controlled trial evaluated the efficacy of a guided IMI with integrated VRET for treating PD and AG. Patients (N = 32) were either assigned to the experimental group receiving the IMI with VRET, or the active control group receiving sessions covering stress education and relaxation. The primary outcome, self-reported symptom severity via panic and agoraphobia scale, was assessed at four points: baseline, interim, post-intervention, and follow-up. As the secondary outcome, clinician-rated remission via MINI-Dips was assessed at follow-up. A mixed-effects ANOVA revealed a significant symptom reduction over time (F = 17.85, p < .001, η²_m = .43), without main (F = 1.58, p = .21, η²_m = .05) or interaction effects (F = .719, p = .54, η²_m = .03). Yet, the experimental group showed a significantly higher remission rate at follow-up (χ² (1) = 4.57, p = .033, w = .378). Both groups experienced similar self-reported symptom alleviation at post-treatment and follow-up. Elevated clinician-rated remission rate in the experimental group points towards the supplementary merit of VRET in this treatment. Differences in the clinician- and self-reported outcomes underscore the importance of multilayered research approaches.