Symptoms of psychosis include hearing voices and hallucinations.
A team of researchers has conducted a phase 2/3 clinical trial using a digital avatar that, in the short term, helps reduce the distress of people with psychosis who hear voices.
The randomized controlled trial of 345 patients tested two types of a new therapy called ‘Avatar’: after 16 weeks, both were more effective than standard treatment at reducing patients’ discomfort, and both reduced the severity of auditory hallucinations.
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Regarding the frequency of voices, only one of the two avatar therapies (the most advanced) managed to reduce it after 28 weeks of treatment.
Details of the trial conducted by a team of British researchers were published Monday in the journal Nature Medicine.
Psychosis is a disorder that refers to a set of symptoms that cause a person to become disconnected from their reality . Individuals who suffer from it experience delusions, hallucinations, hear voices, and may speak incoherently or behave inappropriately.
In this study, led by Philippa Garety of King’s College London, the team tested the effectiveness of two forms of Avatar therapy given alongside standard UK treatment for adults with psychosis who hear distressing voices.
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The therapy had two versions: a brief one (Avatar-Brief), in which the avatar enhanced assertiveness and self-esteem, and an extended one (Avatar-Extended), tuned by the patient, which included a series of more personalized dialogues based on the life history of the participants.
They found that patients who received extended therapy had clinically significant improvements in voice distress and severity levels at 16 weeks, but not at 28 weeks, and reductions in voice frequency at both 16 weeks and 28 weeks, compared with those who received usual care alone.
Those who received Avatar-Brief therapy had a higher completion rate (82%) than those who received AVATAR-Extended (58%).
Overall, Avatar-Extended showed a wider range of positive effects and these tended to be stronger and longer lasting.
The results suggest that Avatar therapy, combined with standard treatment, may lead to improvements in voice-related symptoms among people with psychosis who hear distressing voices.
Expert opinion varies
Celso Arango, director of the Institute of Psychiatry and Mental Health at the Gregorio Marañón General University Hospital in Spain, said that the study was very well conducted and had a sufficient sample size.
However, the trial leaves unresolved questions , such as identifying which patients can benefit from the treatment, “especially since only 58% of those assigned the most personalized treatment completed the study,” and knowing by what mechanism they manage to reduce discomfort.
Meanwhile, psychiatrist and vice-secretary of the Board of the Spanish Association of Neuropsychiatry, José García-Valdecasas, does not believe that these findings will have clinical relevance.
