Virtual reality cognitive training shows potential for treating adolescents with depression

A study examining the effects of virtual reality cognitive training on Chinese adolescents with mild to moderate depression found that participants’ cognitive performance improved after treatment, and depressive symptoms decreased as well. The research was published in Psychiatry Research.

Individuals with depression often experience cognitive impairments in addition to other symptoms of the condition, which further exacerbates their disease burden. Cognitive impairment in adolescents with depression often affects areas such as attention, memory, executive function, and processing speed, interfering with academic performance and daily activities. Depressed adolescents may struggle with concentration, leading to difficulties in completing tasks or retaining information.

These impairments are thought to stem from disruptions in brain regions like the prefrontal cortex and hippocampus, as well as imbalances in neurotransmitters such as serotonin and dopamine. Cognitive deficits in depression can persist even during periods of remission, potentially impacting long-term development and quality of life.

Study author Sihui Lyu and her colleagues conducted research to explore the effectiveness of virtual reality cognitive training in improving the cognitive functioning of adolescents with mild to moderate depressive episodes. They hypothesized that this training strategy would both improve participants’ cognitive performance and reduce depressive symptoms.

The study included 93 adolescents with depression and 44 healthy adolescents. Healthy participants were recruited from the community and through online media advertisements, while adolescents with depression were recruited from the First Affiliated Hospital of Jinan University in Guangzhou, China. Participants were between the ages of 12 and 17.

At the start of the study, adolescents with depression were randomly assigned to either undergo a virtual reality cognitive training program or be part of the waitlist control group (a group not receiving treatment during the study but informed they would undergo treatment afterward). Healthy adolescents only completed clinical assessments at the beginning and end of the study.

Participants completed a clinical interview to assess depression symptoms and a cognitive assessment evaluating four cognitive processes: planning, attention, simultaneous processing, and successive processing. These assessments were conducted at the start and end of the study.

The virtual reality cognitive training program required participants to wear virtual reality equipment and complete two training modules. One module aimed to improve attention, while the other targeted working memory. Each module consisted of five training tasks. The training was delivered in 20 sessions, each lasting 30 minutes, over the course of seven weeks. In each session, participants completed three randomly chosen tasks. By the end of the training, all participants had completed all tasks, with each task being repeated four to eight times. During this period, participants in the waitlist group received standard treatment for depression.

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Results showed that depressed adolescents performed worse on cognitive tasks at the start of the study compared to healthy adolescents. There was no initial difference in cognitive performance between the two groups of depressed participants. However, after the treatment, the group that underwent virtual reality cognitive training demonstrated significant improvement in all four types of cognitive processes compared to both the waitlist group and their own baseline results. The improvements ranged from moderate to large in magnitude.

At the start of the study, the average severity of depressive symptoms was similar in the two groups of depressed adolescents. After the treatment, depressive symptoms in the cognitive training group improved substantially.

“Our intervention results suggest that the VRCT [virtual reality cognitive training] program may improve cognitive functions and alleviate emotional symptoms in adolescents with mild to moderate depressive episodes. Tailoring intervention strategies that integrate technology to target cognitive impairments could offer valuable additions to existing treatment options, promoting full recovery and fostering positive developmental trajectories in this group,” the study authors concluded.

The study provides preliminary evidence for the effectiveness of a novel method for potentially treating adolescents with depression. However, it is important to note that all assessments were either based on self-reports or highly dependent on participants’ motivation. Additionally, training group participants were fully aware of researchers’ expectations and the purpose of the intervention, making it likely that the observed effects were at least partly influenced by the Hawthorne effect—where participants alter their behavior to align with perceived expectations.

The paper, “Effects of virtual reality-based cognitive training for adolescents with depressive episodes: A pilot randomized controlled study,” was authored by Sihui Lyu, Shuming Zhong, Yange Luo, Shuya Yan, Hanglin Ran, Manying Duan, Kailin Song, Kaiwei Ye, Haofei Miao, Yilei Hu, Zijin Song, Shunkai Lai, Yiliang Zhang, Jiali He, Yunxia Zhu, and Yanbin Jia.