A systematic review of randomized controlled trials on immersive virtual reality for treating anxiety disorders
M.H.C. Cheng, Chun Kit Jacky Chan, Y. T. Au Yeung, L.M.E. Wong, W.H.P. Cheung, K.K. Chu, Sui-Hua Ho, C.K.J. Chan · Clinical Simulation in Nursing · 2025
Background Comprehensive evaluations of virtual reality (VR) therapy across various anxiety conditions remain limited. This review evaluates the effectiveness of VR therapy compared to non-VR treatments for anxiety disorders and provide an up-to-date overview. Methods The PRISMA guidelines were followed for reporting of this review. A systematic search of PubMed, CINAHL Complete, and Embase was conducted from August 2014 to August 2024. Randomized controlled trials (RCTs) comparing VR to non-VR treatments for anxiety disorders were included. Study quality was assessed using the Cochrane risk-of-bias tool. Results Analysis of 23 RCTs (n = 1,216 participants) revealed VR treatment is particularly effective for specific phobias and social anxiety disorder, demonstrating comparable efficacy to non-VR treatment. Outcomes for generalized anxiety disorder, agoraphobia, and panic disorder were less robust. While self-guided interventions showed promise, therapist involvement enhanced efficacy. Discussion VR therapy presents a viable alternative to traditional treatments, though limitations include demographic biases and inconsistent protocols. Future research should focus on underrepresented populations. The findings highlight the potential for nurse-led VR interventions to improve accessibility in mental health care.