Effects and safety of virtual reality-based mindfulness in patients with psychosis: a randomized controlled pilot study.
Bo-Mi Lee, Sung-Wan Kim, Bong Ju Lee, Seung-Hee Won, Yong-Han Park, Chae Yeong Kang, Ling Li, Fatima Zahra Rami, Young-Chul Chung
Schizophrenia September 13, 2023 DOI: 10.1038/s41537-023-00391-8 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Randomized controlled trial (pilot) Pilot study Peer reviewed |
|---|---|
| Sample size | 64 |
| Population | Patients with psychosis |
| Interventions | Virtual reality-based mindfulness (VBM) VR control |
| Duration | 8 weekly sessions, each about 30 minutes |
| Measures | Experiences Questionnaire (EQ), Psychotic Symptom Rating Scales-Delusion (PSYRATS-D), PSYRATS-Auditory Hallucinations (PSYRATS-AH), Motivation and Pleasure Scale-Self Rating (MAP-SR), safety questionnaire, skin conductance level (SCL), heart rate (HR), RR interval |
| Topics | Meditation |
| Key findings | VBM was not more effective than VR control for decentering or psychiatric symptoms, with no significant group-by-time or main effects on those scales. Within the VBM group, decentering increased and PSYRATS-D preoccupation amount and duration decreased, and a group-by-time interaction appeared for MAP-SR close-relationship feelings. VR sickness was frequent but mild. |
Abstract
Virtual reality (VR) technology can be a supporting tool to enhance mindfulness. Recently, many research using VR-based mindfulness (VBM) has been carried out in various psychiatric disorders but not in psychosis. We investigated safety and effects of virtual reality-based mindfulness (VBM) in patients with psychosis as a pilot study. Sixty-four patients were randomly assigned to VBM or to VR control. For VBM, education and meditation videos were provided. For VR control, 3-dimensional natural scenes were shown. Both programs consisted of 8 weekly sessions, each lasting about 30 min. Pre- and post-assessments were performed using the experiences questionnaire (EQ), psychotic symptom rating scales-delusion (PSYRATS-D), PSYRATS-auditory hallucinations (AH), motivation and pleasure scale-self rating (MAP-SR) and etc. The safety questionnaire was also surveyed after 1st and 8th session. Physiological measures such as skin conductance level (SCL), heart rate (HR) and RR interval, were collected during the VR interventions. Limited individuals participated in the safety questionnaire and physiological measures. All the results were presented in mean and standard deviation. We did not observe significant results in group x time interaction and main effects of group and time in the decentering and clinical scales. However, within group comparison showed that patients randomized to VBM showed increased decentering (p = 0.029) and decreased amount (p = 0.032) and duration of preoccupation (p = 0.016) in the PSYRATS-D. For the feelings and motivations about close caring relationships of the MAP-SR, we observed a significant group x time interaction (p = 0.027). The frequency of VR sickness was high but its severity was mild. There were significant differences only in HR over time in the VBM group (p = 0.01). These results suggest that VBM was not more effective in reducing decentering and psychiatric symptoms than VR control but its adversity was modest.
Comparable studies
Other randomized controlled trials on meditation, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Alterations in Brain and Immune Function Produced by Mindfulness Meditation Healthy employees in a work environment | 2003 | Randomized controlled trial | n = 41 |
| Prevention of relapse/recurrence in major depression by mindfulness-based cognitive therapy. Recovered recurrently depressed patients | 2000 | Randomized controlled trial | n = 145 |
| Open hearts build lives: Positive emotions, induced through loving-kindness meditation, build consequential personal resources. Working adults | 2008 | Randomized controlled trial | n = 139 |
| Short-term meditation training improves attention and self-regulation Undergraduate Chinese students | 2007 | Randomized controlled trial | n = 40 |
| Mindfulness-Based Cognitive Therapy for Depression: Replication and Exploration of Differential Relapse Prevention Effects. Recovered recurrently depressed patients | 2004 | Randomized controlled trial | n = 73 |
Citations in the library
Cited by 5
- The application of virtual reality meditation and mind-body exercises among older adults. Frontiers in Psychology 2024
- Exploring technology-assisted mindfulness: a systematic progressive review on the role of virtual reality Virtual Reality September 2, 2025
- A systematic review on mindfulness-based immersive interventions in depressive disorders npj Mental Health Research April 2, 2026
- Effects of virtual reality mindfulness interventions on depression and anxiety: a meta-analysis European Journal of Psychotraumatology May 26, 2026
- Efficacy of Virtual Reality-Based Mindfulness Interventions: Systematic Review and Meta-Analysis. JMIR XR and spatial computing 2026
Cites 12
- Loving-kindness and compassion meditation: potential for psychological interventions. Clinical Psychology Review July 26, 2011
- Should Mindfulness for Health Care Workers Go Virtual? A Mindfulness-Based Intervention Using Virtual Reality and Heart Rate Variability in the Emergency Department. Workplace Health & Safety April 2023
- Classification of Mindfulness Meditation and Its Impact on Neural Measures in the Clinical Population. Frontiers in Psychology 2022
- Mindfulness in severe and persistent mental illness: a systematic review. International Journal of Psychiatry in Clinical Practice November 2018
- Mindfulness-based relapse prevention combined with virtual reality cue exposure for methamphetamine use disorder: Study protocol for a randomized controlled trial. Contemporary Clinical Trials July 2018
and 7 more in the library