Evidence map›Paper›PMID 36343472›Full record

Trial reportSchizophrenia research2022

Agoraphobic avoidance in patients with psychosis: Severity and response to automated VR therapy in a secondary analysis of a randomised controlled clinical trial.

Daniel Freeman, Sinéad Lambe, Ushma Galal, Ly-Mee Yu, Thomas Kabir, Ariane Petit, Laina Rosebrock, Robert Dudley, Kate Chapman, Anthony Morrison and 10 more

Open access · hybridAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Schizophrenia research, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed
2.1field-weighted citation impact, top 12% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

8 citing papers in PubMed, 15 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

20 authors at 8 institutions in 1 country.

Daniel FreemanDepartment of Psychiatry, University of Oxford, Oxford, UK; Oxford Health NHS Foundation Trust, Oxford, UK. Electronic address: daniel.freeman@psych.ox.ac.uk.
Sinéad LambeDepartment of Psychiatry, University of Oxford, Oxford, UK; Oxford Health NHS Foundation Trust, Oxford, UK.
Ushma GalalOxford Primary Care Clinical Trials Unit, Nuffield Department of Primary care Health Sciences, University of Oxford, Oxford, UK.
Ly-Mee YuOxford Primary Care Clinical Trials Unit, Nuffield Department of Primary care Health Sciences, University of Oxford, Oxford, UK.
Thomas KabirMcPin Foundation, London, UK.
Ariane PetitDepartment of Psychiatry, University of Oxford, Oxford, UK.
Laina RosebrockDepartment of Psychiatry, University of Oxford, Oxford, UK; Oxford Health NHS Foundation Trust, Oxford, UK.
Robert DudleyCumbria, Northumberland, Tyne, and Wear NHS Foundation Trust, Newcastle upon Tyne, UK; Newcastle University, Newcastle upon Tyne, UK.
Kate ChapmanAvon and Wiltshire Mental Health Partnership (AWP) NHS Trust, Bath, UK.
Anthony MorrisonGreater Manchester Mental Health Foundation Trust, Manchester, UK; Division of Psychology and Mental Health, University of Manchester, Manchester, UK.
Eileen O'ReganNottinghamshire Healthcare NHS Foundation Trust, Nottingham, UK.
Elizabeth MurphyGreater Manchester Mental Health Foundation Trust, Manchester, UK.
Charlotte AynsworthCumbria, Northumberland, Tyne, and Wear NHS Foundation Trust, Newcastle upon Tyne, UK.
Julia JonesNottinghamshire Healthcare NHS Foundation Trust, Nottingham, UK.
Rosie PowlingAvon and Wiltshire Mental Health Partnership (AWP) NHS Trust, Bath, UK.
Jenna GrabeyOxford Primary Care Clinical Trials Unit, Nuffield Department of Primary care Health Sciences, University of Oxford, Oxford, UK.
Aitor RoviraDepartment of Psychiatry, University of Oxford, Oxford, UK; Oxford Health NHS Foundation Trust, Oxford, UK.
Jason FreemanDepartment of Psychiatry, University of Oxford, Oxford, UK.
David M ClarkOxford Health NHS Foundation Trust, Oxford, UK; Department of Experimental Psychology, University of Oxford, Oxford, UK.
Felicity WaiteDepartment of Psychiatry, University of Oxford, Oxford, UK; Oxford Health NHS Foundation Trust, Oxford, UK.
University of Oxford · GBOxford Health NHS Foundation Trust · GBAvon and Wiltshire Mental Health Partnership NHS Trust · GBMental Health Foundation · GBNottinghamshire Healthcare NHS Foundation Trust · GBCumbria Northumberland Tyne and Wear NHS Foundation Trust · GBMcPin Foundation · GBNewcastle University · GB

Funding

Wellcome Trust
6 · The paper itself

Abstract

backgroundThe social withdrawal of many patients with psychosis can be conceptualised as agoraphobic avoidance due to a range of long-standing fears. We hypothesised that greater severity of agoraphobic avoidance is associated with higher levels of psychiatric symptoms and lower levels of quality of life. We also hypothesised that patients with severe agoraphobic avoidance would experience a range of benefits from an automated virtual reality (VR) therapy that allows them to practise everyday anxiety-provoking situations in simulated environments.

methods345 patients with psychosis in a randomised controlled trial were categorised into average, moderate, high, and severe avoidance groups using the Oxford Agoraphobic Avoidance Scale. Associations of agoraphobia severity with symptom and functioning variables, and response over six months to brief automated VR therapy (gameChange), were tested.

resultsGreater severity of agoraphobic avoidance was associated with higher levels of persecutory ideation, auditory hallucinations, depression, hopelessness, and threat cognitions, and lower levels of meaningful activity, quality of life, and perceptions of recovery. Patients with severe agoraphobia showed the greatest benefits with gameChange VR therapy, with significant improvements at end of treatment in agoraphobic avoidance, agoraphobic distress, ideas of reference, persecutory ideation, paranoia worries, recovering quality of life, and perceived recovery, but no significant improvements in depression, suicidal ideation, or health-related quality of life.

conclusionsPatients with psychosis with severe agoraphobic avoidance, such as being unable to leave the home, have high clinical need. Automated VR therapy can deliver clinical improvement in agoraphobia for these patients, leading to a number of wider benefits.

Indexed as

Cognitive Behavioral TherapyPsychotic DisordersVirtual Reality Exposure TherapyAgoraphobiaHumansQuality of LifeAgoraphobiaHallucinationsParanoiaSchizophreniaTherapyVirtual reality (VR)

Identifiers

PMID36343472
PMCPMC10914663
OpenAlexW4308308727

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.