ORIGINAL RESEARCH
Neurology
doi: 10.25005/2074-0581-2025-27-4-856-863
USING VIRTUAL REALITY EXPOSURE THERAPY IN THE TREATMENT OF SEVERE ANXIETY IN SOMATIC SYMPTOM AND RELATED DISORDERS

A.V. ALTMAN1, E.V. MAZANKINA2, I.G. ТRUKHANOVA3

1Dr. Bobova's Clinic, Samara, Russian Federation
2Department of General and Clinical Psychology, Samara State Medical University, Samara, Russian Federation
3Department of Anesthesiology, Intensive Care and Emergency Medicine, Institute of Vocational Education, Samara State Medical University, Samara, Russian Federation

Objective: To evaluate the impact of virtual reality (VR) breathing training intervention on the level of anxiety, depression, and physiological markers of stress, such as salivary cortisol, in the treatment of severe anxiety in somatic symptom and related disorders (SSRDs)

Methods: : Fifty-eight participants (mean age 37.94±1.9 years) with SSRDs, as classified by DSM-5 and formerly known as somatoform disorders (ICD-10 code F.45), took part in the study. The study participants included 14 men (24.1%) with a mean age of 38.24±1.91 years and 44 women (75.9%) with a mean age of 37.85±1.89 years. To create a VR scene featuring the sky and a receding water surface on the horizon, the Oculus Rift S PC-Powered VR Gaming Headset (Reality Labs division, Menlo Park, CA, USA) was used. Biofeedback-guided breathing training was implemented using the TRsens nasal-oral respiratory temperature sensor and a KARDi2-NP polygraph amplifier (Medical Computer Systems LLC, Moscow, Russia). Participants' emotional states were assessed before the first training session and after the fifth session using the Hamilton Anxiety Rating Scale, the SpielbergerKhanin Rating Scale, and the Hospital Anxiety and Depression Scale (HADS). Salivary cortisol levels were measured before and after the first session, as well as after five sessions.

Results: A positive trend in salivary cortisol levels was observed across the entire study cohort, with a decrease from 6.65 to 5.17 nmol/L (p=0.001). This decrease was also significant when analyzed separately for men, whose levels dropped from 6.44 to 4.87 nmol/L (p<0.001), and women, whose levels decreased from 6.86 to 5.51 nmol/L (p<0.001). Additionally, improvements in patients' emotional states were recorded across all scales before and after five sessions. The results are as follows: Spielberger State Anxiety Scale: Pre-session score was 46.0 [41; 53] and post-session score was 44.0 [38; 52] (p=0.001); Spielberger Trait Anxiety Scale: Pre-session score was 49.5 [43.3; 55.0] and post-session score was 49.0 [41; 52] (p>0.05); Hamilton Anxiety Rating Scale: Pre-session score was 15.0 [4; 18] and post-session score was 11.0 [41; 53] (p=0.002); HADS: Pre-session score was 9.0 [6; 11] and post-session score was 7.0 [5; 9] (p<0.001).

Conclusion: The developed method has shown promise in helping patients respond appropriately to stressful situations. This conclusion is supported by a statistically significant reduction in the emotional exhaustion index, as measured by the study's scales, and a decrease in saliva cortisol levels.

Keywords: Training, virtual reality, biofeedback method, Hamilton scale, Spielberger scale, somatic symptom and related disorders (SSRDs)..

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Authors' information:

Altman Alyona Vladimirovna,
Doctor-Therapist at Dr. Bobova's Clinic
ORCID ID: 0000-0003-4823-1652
E-mail: AltmanAV@yandex.ru

Mazankina Elena Vladimirovna,
Senior Lecturer at the Department of General and Clinical Psychology, Samara State Medical University
ORCID ID: 0000-0002-9014-0191
SPIN: 7873-5232
E-mail: e.v.mazankina@samsmu.ru

Trukhanova Inna Georgievna,
Doctor of Medical Sciences, Full Professor, Head of the Department of Anesthesiology, Intensive Care and Emergency Medicine, Institute of Vocational Education, Samara State Medical University
Scopus ID: 56001844900
ORCID ID: 0000-0002-2191-1087
Author ID: 473620
SPIN: 9672-8355
E-mail: innasmp@yandex.ru

Information about support in the form of grants, equipment, medications

The authors did not receive financial support from manufacturers of medicines and medical equipment

Conflicts of interest: No conflict

Address for correspondence:

Altman Alyona Vladimirovna
Doctor-Therapist at Dr. Bobova's Clinic

443056, Russian Federation, Samara, Stara-Zagora str., 25

Tel.: +7 (927) 7333306

E-mail: AltmanAV@yandex.ru


This work is licensed under a Creative Commons Attribution 4.0 International License.

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