Applications of Virtual Reality in Psychiatry. Systematic Review of the Scientific Literature

Abstract

Virtual reality (VR) is an increasingly investigated technology in psychiatry, with applications spanning both therapeutic and diagnostic interventions. This systematic review synthesizes evidence from systematic reviews, meta-analyses, and randomized controlled trials concerning the use of VR across major psychiatric disorders. The strongest evidence supports virtual reality exposure therapy (VRET) for anxiety disorders and specific phobias, with therapeutic effects comparable to in vivo exposure in several conditions and non-inferiority to conventional cognitive-behavioral therapy in social anxiety disorder. VR-based interventions also demonstrate beneficial effects in post-traumatic stress disorder, although their efficacy appears broadly comparable to standard treatments. In psychotic disorders, emerging evidence suggests improvements in positive and negative symptoms and cognitive functioning, including through AVATAR therapy, while evidence regarding social functioning remains limited. VR interventions may also contribute to improvements in body image, binge-eating and purging behaviors in eating disorders, and may facilitate craving assessment and cueexposure therapy in substance use disorders. Additionally, virtual environments show potential for ADHD assessment, autism-related social-skills training, and cognitive rehabilitation. Despite these promising findings, methodological limitations—including small samples, heterogeneous protocols, inadequate control groups, and limited blinding—restrict definitive conclusions. Overall, VR represents a promising adjunctive tool in psychiatry, but further high-quality research is required before widespread clinical implementation.