Ulrik Nykjær Jeppesen
I'm a medical doctor highly interested in psychiatry, especially schizophrenia spectrum disorders. There is a need for improving the treatment that we offer people suffering from these distressing conditions. And these improvements can be made by using and developing several different approaches such as the social, psychological, biological and phenomenological.
My PhD project is based on the randomized clinical trial "Face Your Fears" conducted in collaboration with Copenhagen Research Center for Mental Health (CORE), Psykiatrisk Center København.
The project is funded by Trygfoundation, Independent Research Fund Denmark and the Capitol Region of Denmark.
Face Your Fears: Virtual reality-based cognitive behavioral therapy (VR-CBT) versus standard CBT for paranoid ideations in patients with schizophrenia spectrum disorders: A randomized clinical trial
Schizophrenia Spectrum disorders cause tremendous suffering for patients, relatives, and the surrounding society. Paranoid ideations, encompassing ideas of social reference and manifest persecutory delusions, are among the most frequent symptoms in this population and a cause of significant distress. Recent meta-analyses of Cognitive Behavioral Therapy (CBT) for psychosis show small to moderate effect sizes in reducing paranoid ideations. Virtual Reality based CBT (VR-CBT) could improve therapy efficacy as exposure and behavioral experiments in VR can be optimized, individualized and carried out in a safe environment. Few VR-CBT studies exist for paranoid ideations and there is a need for large scale, methodological rigorous trials.
This study is a randomized, assessor-blinded parallel-groups multi-centre superiority clinical trial, fulfilling the CONSORT criteria for non-pharmacological treatment. A total of 256 patients diagnosed with schizophrenia spectrum disorder, including schizotypal disorder (ICD-10 F20-29), will be allocated to 10 sessions of symptom specific CBT-VR plus treatment as usual - versus 10 sessions of standard symptom specific CBT for paranoid ideations (CBT) plus treatment as usual. All participants will be assessed at baseline, treatment end (3 months post baseline) and then 9 months post baseline. A stratified block-randomization with concealed randomization sequence will be conducted. Independent assessors blinded to the treatment will evaluate outcome. Analysis of outcome will be carried out with the intention to treat principles.
The primary outcome is ideas of social reference measured with Green Paranoid Thought Scale Part A (GPTS-A) at cessation of treatment at 3 months post baseline. Secondary outcomes are ideas of persecution (GPTS-B); Social Interaction Anxiety Scale (SIAS); Personal and Social Performance scale (PSP); Safety Behavior Questionnaire (SBQ) and CANTAB Emotion Recognition Task.
The trial will elucidate whether VR-CBT can enhance therapy efficacy for paranoid ideations. Additionally, Trial findings will provide evidence on effectiveness and cost-effectiveness of VR-CBT for paranoid ideations that can guide the possible dissemination and implementation into clinical practice.