Virtual reality-assisted therapy targeting persistent auditory verbal hallucinations in patients diagnosed with schizophrenia spectrum disorders: the Challenge single-blind, randomized clinical trial

Abstract Auditory verbal hallucinations (AVH) are frequent and debilitating symptoms of schizophrenia spectrum disorders (SSD). In the current randomized, assessor-blinded, parallel-group superiority clinical trial, a total of 270 participants, diagnosed with SSD suffering from treatment-resistant AVH, were randomly assigned to seven sessions of either a virtual reality-assisted therapy (Challenge-VRT) or supportive counselling. Assessment of outcome was conducted at baseline, and at 12 and 24 weeks post baseline. Linear mixed model analyses demonstrated that Challenge-VRT significantly reduced the symptom load of AVH on the primary outcome measured with the Psychotic Symptoms Rating Scales (PSYRATS-AH total, adjusted mean difference: -2.26, 95% Cl: -4.26 to -0.25, p = 0.03) and the secondary outcome measure on frequency of AVH (PSYRATS-Frequency, adjusted mean difference: -0.84, 95% Cl: -1.53 to -0.14, p = 0.02) at treatment cessation 12 weeks post baseline. We conclude that the brief Challenge-VRT is a viable new treatment method for reducing the severity of AVH. ClinicalTrials.gov identifier NCT04661163