CClinicalTrials.gg
CompletedNCT03101332Updated Oct 30, 2020

Virtual Reality for Panic Disorder With Agoraphobia

An interventional study of Virtual Reality cognitive behavior therapy in Panic; Agoraphobia, sponsored by Karolinska Institutet. Completed at 2 sites in Sweden. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2020-10-30.

Sponsored by Karolinska Institutet · Not applicable, Interventional, and Treatment

Phase
Not applicable
Study type
Interventional
Enrollment
12
Allocation
Not applicable
Ages
18 Years and older
Sex
All
01

Study summary

Panic disorder with agoraphobia (PDA) is associated with considerable personal distress, functional disability and societal costs. A large number of studies have shown that Cognitive Behavior Therapy (CBT) is a highly effective treatment for PDA. However, the CBT-protocols proven to be most effective involves repeated exposure to the particular environments the agoraphobic patient fears such as trains, tunnels, lifts and shops. This cause great practical problems for health care services as such therapeutic efforts involves spending considerable time outside the clinic. For primary care services this is particularly challenging due to the large number of patients expected to be seen. Normally clinicians meet up to 7 patients daily which makes it almost practically impossible to offer 2-hour sessions, which is necessary to carry out the relevant exposure tasks. Hence, the treatment proven to be most effective, which primary care services are commissioned to deliver, is too comprehensive and time consuming to be applied in real practice.

The investigators believe that a possible solution to the above problem is to provide evidence-based CBT but with the exposure components carried out through Virtual Reality (VR) rather than in vivo. Some research has already been done with virtual reality and exposure therapy for anxiety disorders with promising results. The aim of this pilot study is to treat patients with agoraphobia with or with a history of panic disorder with a standardized exposure-based CBT-protocol through VR. The virtual environments that are used for the study are live sequences filmed in 360°. The investigators hypothesize that CBT with VR will be effective and lead to improvements on measures of panic disorder and agoraphobia.

02

Conditions studied

  • Panic; Agoraphobia
03

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  • A primary diagnosis of Agoraphobia with or with a history of panic disorder according to the Diagnostic and Statistical Manual of Mental Disorders 5 (DSM-5).
  • Minimum 18 years of age.
  • Able to read and write in Swedish

Exclusion criteria

Exclusion:

  • Other primary axis-I disorder
  • Ongoing substance abuse or addiction
  • Current or previous episode of psychosis or bipolar disorder
  • Severe major depressive disorder:
  • Moderate to severe suicidal risk
  • Non-stable antidepressant medication (changed during the last month) or not agreeing to keep dosage constant throughout the study
  • Ongoing concurrent psychological treatment
  • Having received previous high quality Cognitive Therapy or Cognitive Behavior Therapy for agoraphobia during the recent year
04

Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrollment
12 participants (actual)

Study arms

  • Experimental
    VR-CBT

    Virtual Reality cognitive behavior therapy. 10-12 sessions of individual Cognitive Behavior Therapy with exposure tasks carried out through Virtual Reality.

    Behavioral: Virtual Reality cognitive behavior therapy

Interventions

  • BehavioralVirtual Reality cognitive behavior therapy

    Cognitive interventions targeted to change catastrophic misinterpretations of the physiological symptoms that occur during a panic attack. Exposure via Virtual Reality to filmed sequences of environments typically feared by agoraphobic patients such as underground station/train, a tunnel, a lift and a public square, as well as exposure to the feared symptoms that occur in a typical panic attack. Interventions are delivered by a psychologist in face-to-face sessions.

05

What researchers measure

Primary outcomes

  1. Mobility Inventory

    Change at post-treatment (10 weeks), 6-month follow-up, and 12 month follow-up compared to baseline

    Time frame: Baseline, post-treatment (10 weeks), 6-month follow-up, 12-month follow-up

Secondary outcomes

  1. Panic disorder severity scale

    Change at post-treatment (10 weeks), 6-month follow-up, and 12 month follow-up compared to baseline

    Time frame: Baseline, post-treatment (10 weeks), 6-month follow-up, 12-month follow-up

  2. Patient Health Questionnaire

    Change at post-treatment (10 weeks), 6-month follow-up, and 12 month follow-up compared to baseline

    Time frame: Baseline, post-treatment (10 weeks), 6-month follow-up, 12-month follow-up

  3. World Health Organisation Disability Assessment Schedule

    Change at post-treatment (10 weeks), 6-month follow-up, and 12 month follow-up compared to baseline

    Time frame: Baseline, post-treatment (10 weeks), 6-month follow-up, 12-month follow-up

  4. The World Health Organisation Quality of Life

    Change at post-treatment (10 weeks), 6-month follow-up, and 12 month follow-up compared to baseline

    Time frame: Baseline, post-treatment (10 weeks), 6-month follow-up, 12-month follow-up

Other outcomes

  1. Presence Questionnaire

    Means and standard deviations will be presented. No change is hypothesized for this measure

    Time frame: Week 1, week, 2, week3, week 4, week 5, week 6, week 7, week 8, week 9, week 10

06

Study locations

2 sites
  • Gustavsberg primary care center
    Gustavsberg, Stockholm 13440, Sweden
  • Karolinska Institutet
    Stockholm, 17177, Sweden
07

References and documents

Individual participant data

Plan to share: No

No publications or documents are linked to this record.

08

Registry details

Key details

Study ID
NCT03101332
Lead sponsor
Karolinska Institutet
Responsible party
Erik Hedman (Principal investigator, PhD, Karolinska Institutet) — Principal investigator
First posted
Apr 5, 2017
Start date
May 1, 2017
Primary completion
Jun 18, 2019
Completion
Jun 18, 2019
Last update
Oct 30, 2020

Study contacts

Erik Hedman, PhD
principal investigator · Karolinska Institutet

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
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