Virtual reality-based cognitive remediation in severe mental illness: Current evidence from a narrative review

Cognitive impairment is a pervasive feature across severe mental illnesses (SMIs), including schizophrenia spectrum disorders (SSDs), major depressive disorder (MDD), and bipolar disorder (BD), and is associated with poor functional outcomes and reduced quality of life. Cognitive remediation (CR) is an evidence-based psychosocial intervention aimed at improving cognitive functioning and daily functioning in individuals with SMI. In recent years, virtual reality (VR) has emerged as a promising modality for delivering CR in a more immersive, engaging, and ecologically valid manner. This narrative review synthesizes the current literature on the effectiveness of fully immersive VR-based CR interventions in SMI populations. Preliminary findings suggest that VR-CR may enhance treatment engagement, facilitate transfer of cognitive gains to real-life functioning, and support remote delivery. Although early results are encouraging, most available studies are limited by small sample sizes, short follow-up periods, and lack of standardized outcome measures. Further large-scale randomized controlled trials are needed to establish the long-term effectiveness, generalizability, and cost-efficiency of VR-CR approaches.