O impacto da terapia de exposição à realidade virtual no tratamento de TEPT e transtornos de ansiedade

Autores

DOI:

https://doi.org/10.25118/2763-9037.2024.v14.1319

Palavras-chave:

terapia de exposição à realidade virtual (VRET), transtorno de estresse pós-traumático (TEPT), transtornos de ansiedade, dessensibilização, terapia imersiva, personalização de tratamento, inovação em saúde mental

Resumo

A Terapia de Exposição à Realidade Virtual (VRET) surgiu como uma ferramenta inovadora no tratamento do Transtorno de Estresse Pós-Traumático (TEPT) e transtornos de ansiedade, oferecendo um ambiente controlado e imersivo que facilita a dessensibilização e a extinção do medo. O processo de revisão seguiu rigorosamente as diretrizes PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses). Esta revisão da literatura explora os mecanismos pelos quais o VRET melhora os resultados terapêuticos, comparando a sua eficácia com as terapias de exposição tradicionais. Através de uma análise das aplicações clínicas, particularmente no TEPT e em vários transtornos de ansiedade, a revisão destaca tanto as vantagens do VRET – como o maior envolvimento do paciente e a personalização do tratamento – como os seus desafios, incluindo limitações tecnológicas e considerações éticas. Também são discutidas as direções futuras para VRET, enfatizando seu potencial para revolucionar os cuidados de saúde mental, integrando avanços em tecnologia e abordagens de tratamento personalizadas.

Downloads

Não há dados estatísticos.

Métricas

Carregando Métricas ...

Biografia do Autor

Kirolos Eskandar, Diakonie Klinik Mosbach, Mosbach, Baden Württemberg, Germany

xx

Referências

Malbos E. Virtual reality in exposure therapy: the next frontier. In: Aboujaoude E, Starcevic V, editors. Mental health in the digital age: grave dangers, great promise. New York: Oxford Academic; 2015. https://doi.org/10.1093/med/9780199380183.003.0012 DOI: https://doi.org/10.1093/med/9780199380183.003.0012

Geraets CNW, Veling W, Witlox M, Staring ABP, Matthijssen SJMA, Cath D. Virtual reality-based cognitive behavioural therapy for patients with generalized social anxiety disorder: a pilot study. Behav Cogn Psychother. 2019;47(6):745-50. https://doi.org/10.1017/s1352465819000225 PMID:30915939 DOI: https://doi.org/10.1017/S1352465819000225

Kahlon S, Lindner P, Nordgreen T. Virtual reality exposure therapy for adolescents with fear of public speaking: a non-randomized feasibility and pilot study. Child Adolesc Psychiatry Ment Health. 2019;13:47. https://doi.org/10.1186/s13034-019-0307-y PMID:31890004 - PMCID:PMC6933883 DOI: https://doi.org/10.1186/s13034-019-0307-y

Yuen EK, Goetter EM, Stasio MJ, Ash P, Mansour B, McNally E, Sanchez M, Hobar E, Forte S, Zulaica K, Watkins J. A pilot of acceptance and commitment therapy for public speaking anxiety delivered with group videoconferencing and virtual reality exposure. J Contextual Behav Sci. 2019;12:47-54. https://doi.org/10.1016/j.jcbs.2019.01.006 DOI: https://doi.org/10.1016/j.jcbs.2019.01.006

Boeldt D, McMahon E, McFaul M, Greenleaf W. Using virtual reality exposure therapy to enhance treatment of anxiety disorders: identifying areas of clinical adoption and potential obstacles. Front Psychiatry. 2019;10:773. https://doi.org/10.3389/fpsyt.2019.00773 PMID:31708821 - PMCID:PMC6823515 DOI: https://doi.org/10.3389/fpsyt.2019.00773

Kothgassner OD, Goreis A, Kafka JX, Van Eickels RL, Plener PL, Felnhofer A. Virtual reality exposure therapy for posttraumatic stress disorder (PTSD): a meta-analysis. Eur J Psychotraumatol. 2019;10(1):1654782. https://doi.org/10.1080/20008198.2019.1654782 PMID:31489138 - PMCID:PMC6713125 DOI: https://doi.org/10.1080/20008198.2019.1654782

Carl E, Stein AT, Levihn-Coon A, Pogue JR, Rothbaum B, Emmelkamp P, Asmundson GJG, Carlbring P, Powers MB. Virtual reality exposure therapy for anxiety and related disorders: a meta-analysis of randomized controlled trials. J Anxiety Disord. 2019;61:27-36. https://doi.org/10.1016/j.janxdis.2018.08.003 PMID:30287083 DOI: https://doi.org/10.1016/j.janxdis.2018.08.003

Ling Y, Nefs HT, Morina N, Heynderickx I, Brinkman WP. A meta-analysis on the relationship between self-reported presence and anxiety in virtual reality exposure therapy for anxiety disorders. PLoS One. 2014;9(5):e96144. https://doi.org/10.1371/journal.pone.0096144 PMID:24801324 - PMCID:PMC4011738 DOI: https://doi.org/10.1371/journal.pone.0096144

Kaplan AD, Cruit J, Endsley M, Beers SM, Sawyer BD, Hancock PA. The effects of virtual reality, augmented reality, and mixed reality as training enhancement methods: a meta-analysis. Hum Factors. 2021;63(4):706-26. https://doi.org/10.1177/0018720820904229 PMID:32091937 DOI: https://doi.org/10.1177/0018720820904229

Rothbaum BO, Rothbaum JO. Virtual reality exposure therapy advances and potential for clinical and experimental use. Neuropsychopharmacology. 2024. Epub ahead of print. https://doi.org/10.1038/s41386-024-01930-2 PMID:39020139 DOI: https://doi.org/10.1038/s41386-024-01930-2

Heo S, Park JH. Effects of virtual reality-based graded exposure therapy on PTSD symptoms: a systematic review and meta-analysis. Int J Environ Res Public Health. 2022;19(23):15911. https://doi.org/10.3390/ijerph192315911 PMID:36497989 - PMCID:PMC9735589 DOI: https://doi.org/10.3390/ijerph192315911

Gerardi M, Rothbaum BO, Ressler K, Heekin M, Rizzo A. Virtual reality exposure therapy using a virtual Iraq: case report. J Trauma Stress. 2008;21(2):209-13. https://doi.org/10.1002/jts.20331 PMID:18404648 - PMCID:PMC3734540 DOI: https://doi.org/10.1002/jts.20331

Donnelly MR, Reinberg R, Ito KL, Saldana D, Neureither M, Schmiesing A, Jahng E, Liew SL. Virtual reality for the treatment of anxiety disorders: a scoping review. Am J Occup Ther. 2021;75(6):7506205040. https://doi.org/10.5014/ajot.2021.046169 PMID:34817595 - PMCID:PMC8742249 DOI: https://doi.org/10.5014/ajot.2021.046169

Maples-Keller JL, Bunnell BE, Kim SJ, Rothbaum BO. The use of virtual reality technology in the treatment of anxiety and other psychiatric disorders. Harv Rev Psychiatry. 2017;25(3):103-13. https://doi.org/10.1097/hrp.0000000000000138 PMID:28475502 - PMCID:PMC5421394 DOI: https://doi.org/10.1097/HRP.0000000000000138

Wu J, Sun Y, Zhang G, Zhou Z, Ren Z. Virtual reality-assisted cognitive behavioral therapy for anxiety disorders: a systematic review and meta-analysis. Front Psychiatry. 2021;12:575094. https://doi.org/10.3389/fpsyt.2021.575094 PMID:34366904 - PMCID:PMC8342859 DOI: https://doi.org/10.3389/fpsyt.2021.575094

Valmaggia LR, Latif L, Kempton MJ, Rus-Calafell M. Virtual reality in the psychological treatment for mental health problems: an systematic review of recent evidence. Psychiatry Res. 2016;236:189-95. https://doi.org/10.1016/j.psychres.2016.01.015 PMID:26795129 DOI: https://doi.org/10.1016/j.psychres.2016.01.015

Polak M, Tanzer N, Carlbring P. PROTOCOL: effects of virtual reality exposure therapy versus in vivo exposure in treating social anxiety disorder in adults: a systematic review and meta-analysis. Campbell Syst Rev. 2022;18(3):e1259. https://doi.org/10.1002/cl2.1259 PMID:36909890 - PMCID:PMC9246294 DOI: https://doi.org/10.1002/cl2.1259

Ferraioli F, Culicetto L, Cecchetti L, Falzone A, Tomaiuolo F, Quartarone A, Vicario CM. Virtual reality exposure therapy for treating fear of contamination disorders: a systematic review of healthy and clinical populations. Brain Sci. 2024;14(5):510. https://doi.org/10.3390/brainsci14050510 PMID:38790488 - PMCID:PMC11118862 DOI: https://doi.org/10.3390/brainsci14050510

Vats S, Joshi R. The impact of virtual reality in education: a comprehensive research study. In: Sharma SK, Dwivedi YK, Metri B, Lal B, Elbanna A, editors. Transfer, diffusion and adoption of next-generation digital technologies. International Working Conference on Transfer and Diffusion of IT; 2023 Dec 15-16; India. Cham: Springer; 2023. p. 126-36. https://doi.org/10.1007/978-3-031-50204-0_11 DOI: https://doi.org/10.1007/978-3-031-50204-0_11

Soret R, Montes-Solano AM, Manzini C, Peysakhovich V, Fabre EF. Pushing open the door to reality: on facilitating the transitions from virtual to real environments. Appl Ergon. 2021;97:103535. https://doi.org/10.1016/j.apergo.2021.103535 PMID:34298387 DOI: https://doi.org/10.1016/j.apergo.2021.103535

Liu Y, Tan W, Chen C, Liu C, Yang J, Zhang Y. A review of the application of virtual reality technology in the diagnosis and treatment of cognitive impairment. Front Aging Neurosci. 2019;11:280. https://doi.org/10.3389/fnagi.2019.00280 PMID:31680934 - PMCID:PMC6813180 DOI: https://doi.org/10.3389/fnagi.2019.00280

Reger GM, Smolenski D, Edwards-Stewart A, Skopp NA, Rizzo AS, Norr A. Does virtual reality increase simulator sickness during exposure therapy for post-traumatic stress disorder? Telemed J E Health. 2019;25(9):859-61. https://doi.org/10.1089/tmj.2018.0175 PMID:30379634 DOI: https://doi.org/10.1089/tmj.2018.0175

Cibeira N, Lorenzo-López L, Maseda A, López-López R, Moreno-Peral P, Millán-Calenti JC. Realidad virtual como herramienta de prevención, diagnóstico y tratamiento del deterioro cognitivo en personas mayores: revisión sistemática. Rev Neurol. 2020;71(6):205-12. https://doi.org/10.33588/rn.7106.2020258 PMID:32895903 DOI: https://doi.org/10.33588/rn.7106.2020258

Rahman MA, Brown DJ, Mahmud M, Harris M, Shopland N, Heym N, Sumich A, Turabee ZB, Standen B, Downes D, Xing Y, Thomas C, Haddick S, Premkumar P, Nastase S, Burton A, Lewis J. Enhancing biofeedback-driven self-guided virtual reality exposure therapy through arousal detection from multimodal data using machine learning. Brain Inform. 2023;10:14. https://doi.org/10.1186/s40708-023-00193-9 PMID:37341863 - PMCID:PMC10284788 DOI: https://doi.org/10.1186/s40708-023-00193-9

Seuling PD, Czernin NS, Schiele MA. Virtual Reality exposure therapy in the treatment of public speaking anxiety and social anxiety disorder. Neurosci Appl. 2024;3:104074. https://doi.org/10.1016/j.nsa.2024.104074 DOI: https://doi.org/10.1016/j.nsa.2024.104074

Publicado

2024-09-17

Como Citar

1.
Eskandar K. O impacto da terapia de exposição à realidade virtual no tratamento de TEPT e transtornos de ansiedade. Debates em Psiquiatria [Internet]. 17º de setembro de 2024 [citado 18º de outubro de 2024];14:1-21. Disponível em: https://revistardp.org.br/revista/article/view/1319

Edição

Seção

Artigos de Revisão

Plaudit