T218. A REAL ENVIRONMENT BASED VIRTUAL REALITY PSYCHOSOCIAL TREATMENT MAY HELP PATIENTS WITH SCHIZOPHRENIA TO INCREASE SOCIAL FUNCTIONING: A PRELIMINARY STUDY
Authors: Hoşgelen Emine Ilgın , Kartelli Faik , Berger Markus , Erinç Simay , Yerlikaya Deniz , Özbek Yağmur , Yener Görsev , Binnur Akdede Berna , Alptekin Koksal 
Published: May 2020

Abstract

Background
Emerging new technologies may lead to the discovery of new treatment techniques in psychiatric disorders. Virtual Reality (VR) is being one of the newly developed techniques that has also taken its place in literature very recently. VR is a new technology for treatment of psychiatric symptoms. This is a pilot study that aims to determine the behavioral and symptomatic response of patients to a real recorded VR environment. In this study, a virtual reality laboratory has been established and a psychosocial treatment program through virtual reality has been developed for patients with schizophrenia. The aim of this study is to investigate the effect of VR psychosocial treatment program on psychosocial functioning in schizophrenia.

Methods
Data were collected from the patients who applied to Dokuz Eylül University School of Medicine, Schizophrenia and Psychosis Outpatient Clinic. Seven schizophrenia patients who met schizophrenia according to DSM-V diagnostic criteria were included into the study. The level of psychosocial functioning was assessed using the Personal and Social Performance Scale (PSP), the positive and negative symptom severity was evaluated using the Positive and Negative Syndrome Scale (PANSS) and social skills were assessed by using the Social Skills Checklist (SSC). The VR psychosocial treatment program included 10 sessions and was carried on for five weeks as twice a week. Each session had different real virtual environment applications including social interaction components such as in a café to buy a beverage, a bazaar or market to do shopping, taking a bus, tram, and/or ferry, etc.

Results
PSP scores were statistically different after and before virtual reality assessment (p=0,018). SSC scores were trend to be significance after the VR application (p=0,062). After five weeks, patients’ the number of going outside home, the places they go and the activities they do have been increased compared to the numbers at the beginning but did not differ in statistically significance. None of the patients reported motion sickness due to exposure to real environment during or after immersive process of VR. There was no significant difference regarding PANSS scores after the VR psychosocial treatment. In this study real environment VR sessions did not trigger positive symptoms of schizophrenia patients.

Discussion
In this preliminary study, we found that the real environment VR psychosocial application is eligible for schizophrenia patients to improve their social skills and daily activities. This study helped patients to experience the real environment without being there and encouraged them to be “really” in there. Soon, cognitive remediation programs and psychosocial functioning therapies may be conducted via VR and may help the patients to cope with their symptoms and daily life difficulties.