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| Name | Class |
|---|---|
| Centre de Recherche de l'Institut Universitaire en santé Mentale de Montréal | OTHER |
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Treatment of verbal hallucinations in schizophrenia is clinically challenging for both the patient and the therapist. For the therapist, one of the main difficulties arises from the impossibility of directly communicating with the entity persecuting the patient. For the patient, the therapeutic process is challenging because it aims at getting to better cope with an entity that keeps repeating stereotyped and abusive sentences without having the emotional strength to reply to the persecutor. To help overcome these clinical challenges, virtual reality enable patients to recreate the face and the voice of their persecutor.The hypothesis is that the engagement of patients in a dialogue with an external representation of their persecutor, with the support of the therapist, would help them to gain better control over their voices.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Avatar therapy | Experimental | Immediate Avatar therapy. |
|
| Treatment-as-usual | Other | Treatment-as-usual then delayed Avatar therapy. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Avatar therapy | Behavioral | Patients will receive 6 sessions of avatar therapy consisting of 45 minute (1 session per week). The therapy will consist in prompting patients to enter in a dialogue with their persecutor to better regulate their emotional responses. Over the course of the therapy, the character of the avatar will progressively become under patients' control. More precisely, the avatar's speech and tone will gradually be changed by the therapist to echo patients' improved ability to regulate their emotions. That is, the avatar will progressively change from being abusive to becoming helpful and supportive. By doing so, the therapy will seek to reinforce patients' feeling of empowerment over their voices. |
| Measure | Description | Time Frame |
|---|---|---|
| Change in Psychotic Symptom Rating Scale - auditory hallucinations | 11-item structured interview assessing the severity of auditory hallucinations | Within 1 week before treatment, within 1 week after treatment, follow-up 3 months |
| Measure | Description | Time Frame |
|---|---|---|
| Change in Beliefs About Voices Questionnaire - Revised | 35-item self-report measure designed to assess key beliefs and responses people have concerning their voice | Within 1 week before treatment, within 1 week after treatment, follow-up 3 months |
| Change in Positive And Negative Syndrome Scale |
| Measure | Description | Time Frame |
|---|---|---|
| Change in Self-reported anxiety, fear and presence | 3-item self-report scale, ranging from 0 (no emotion) to 10 (strongest emotion) | Last 10 min of each therapy session |
Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Alexandre Dumais, MD, Ph.D | Institut Philippe Pinel de Montréal | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Institut Universitaire en Santé Mentale de Montréal | Montreal | Quebec | H1N 3M5 | Canada |
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| ID | Term |
|---|---|
| D006212 | Hallucinations |
| D000090663 | Schizophrenia, Treatment-Resistant |
| D012559 | Schizophrenia |
| ID | Term |
|---|---|
| D010468 | Perceptual Disorders |
| D019954 | Neurobehavioral Manifestations |
| D009461 | Neurologic Manifestations |
| D009422 | Nervous System Diseases |
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Partial crossover design
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| Treatment-as-usual | Other | Treatment as usual will consist of typical or atypical antipsychotic medication and regulars appointments with psychiatrists and others care team members for a period of 6 weeks. |
|
30-item semi-structured interview investigating overall symptoms severity of schizophrenia in the last week |
| Within 1 week before treatment, within 1 week after treatment, follow-up 3 months |
| Change in Beck Depression Inventory - II | 21-item self-report measure assessing depression symptoms over the past 2 weeks | Within 1 week before treatment, within 1 week after treatment, follow-up 3 months |
| Change in Quality of Life Enjoyment and Satisfaction Questionnaire - Short From | 16-item self-report scale measuring enjoyment and satisfaction experienced during the past week in various areas of daily functioning | Within 1 week before treatment, within 1 week after treatment, follow-up 3 months |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D019967 | Schizophrenia Spectrum and Other Psychotic Disorders |
| D001523 | Mental Disorders |