Abstract Background Mild mental disorders are commonly present in clinical practice, and their treatment usually relies on psychological intervention and medication therapy. However, traditional treatment methods have limitations in acceptance and compliance, and there are individual differences in efficacy. In recent years, virtual reality (VR) technology has become a new intervention method that provides a new approach for psychological exposure therapy, cognitive training, and relaxation intervention by simulating controllable immersive environments. Although preliminary studies have shown that VR may improve emotional regulation and cognitive function, its long-term efficacy and predictive indicators for patients with mild mental disorders are not yet clear. The study compared the short-term and long-term efficacy differences between VR intervention group and traditional treatment methods in improving mild anxiety and depression symptoms. To explore the predictive effects of physiological and behavioral indicators of patients before treatment on the efficacy of VR intervention. Methods The study included 328 patients who met the DSM-5 criteria for mild anxiety diagnosis, as well as 150 healthy controls. The patients were randomly assigned to a VR intervention group (n = 164) and a traditional cognitive behavioral therapy (CBT) control group (n = 164). The VR intervention group received an 8-week, twice weekly VR cognitive behavioral exposure training, which included virtual scenario exposure, mindfulness relaxation, and cognitive restructuring modules; The control group received standard CBT face-to-face treatment at the same frequency. All participants completed clinical symptom assessment at baseline, at the end of the intervention, and at 6-month follow-up after the intervention. Using the Hamilton Anxiety Scale (HAMA) and Hamilton Depression Scale (HAMD), and synchronously recording Electroencephalogram (EEG) and Heart Rate Variability (HRV) during VR tasks. Results There was no significant difference in baseline characteristics between the two groups. After the intervention, both the VR group and the CBT group showed significant improvement in symptoms, but the VR group showed a greater decrease in anxiety and depression scores (p.01), and the efficacy was maintained until the follow-up period (p.05), as shown in Fig. 1. Discussion Research has shown that VR based cognitive-behavioral exposure therapy is significantly more effective than traditional CBT in improving mild anxiety, and the effect lasts longer. The immersive, controllable, and concrete intervention environment created by VR technology may enhance situational realism and participation, more effectively activate and correct emotional memory and cognitive patterns related to fear and anxiety, and promote more lasting adaptive changes at the neural level. The study extends the evidence of the effectiveness of VR intervention from specific anxiety disorders to the common spectrum of mild mental disorders, supporting its potential as a cross diagnostic and standardized new intervention tool. Although traditional CBT remains the effective gold standard, VR therapy has shown unique advantages in enhancing treatment attractiveness, overcoming exposure avoidance, and achieving personalized treatment scenarios, which is expected to improve treatment accessibility and compliance. Future research will further analyze the specific active ingredients that make VR effective and explore predictive models that combine them with biomarkers such as EEG and HRV. Funding No. 2025JGZ133; No. 202531719.
Yang et al. (Sun,) studied this question.