Virtual Exposure With Response Prevention for Obsessive-Compulsive Disorder: Randomized Controlled Trial

Area of Science:

• Psychiatry
• Psychology
• Human-Computer Interaction

Background:

• Exposure with response prevention (ERP) is a guideline-recommended treatment for obsessive-compulsive disorder (OCD).
• Therapist and patient barriers often limit the underuse of ERP.
• Virtual reality (VR) presents a potential solution to overcome these barriers.

Purpose of the Study:

• To evaluate the efficacy and acceptance of virtual reality exposure with response prevention (VERP) for contamination OCD (conOCD) and checking OCD (checkOCD).
• To identify factors influencing treatment success in patients undergoing VERP.

Main Methods:

• A randomized controlled trial involving 80 participants with conOCD or checkOCD.
• Participants received either standard outpatient care (CAU) supplemented with 6 weekly VERP sessions or CAU alone.
• Symptom reduction was measured using the Yale-Brown Obsessive-Compulsive Scale at baseline, post-intervention, and 3-month follow-up.

Main Results:

• No significant overall difference in symptom reduction between the VERP and CAU groups.
• Exploratory analyses indicated a trend for greater obsession reduction in checkOCD patients and anxiety reduction in conOCD patients with VERP.
• Treatment was more effective for VERP participants who had not discontinued prior therapy and those with checking behaviors.

Conclusions:

• While VERP did not show overall superiority to CAU, exploratory results suggest potential benefits for specific OCD subtypes.
• Patient satisfaction with VERP was positive, though sense of presence was moderate and unrelated to outcomes.
• Findings are hypothesis-generating and require cautious interpretation, suggesting further research into VERP for specific patient groups.