August 15, 2025Nature MedicineOpen Access

Virtual reality-based versus standard cognitive behavioral therapy for paranoia in schizophrenia spectrum disorders: a randomized controlled trial

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Discussion

Randomized trial found no significant difference in reducing paranoia in schizophrenia using virtual reality versus standard therapy.

VR-CBTp and standard CBTp produced similar outcomes for paranoia, with a 2% effect estimate favoring VR-CBTp, not statistically significant.
Outcomes were measured using the Ideas of Persecution subscale of the Green Paranoid Thoughts Scale at treatment cessation.
In total, 254 participants were randomized to receive either VR-CBTp or CBTp, both along with usual treatment.
Results suggest VR-CBTp did not improve paranoia reduction compared to CBTp; further research may be needed.

Jeppesen et al. (2025) studied this question.

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