Metaverse for mental health disorders: Opportunities and challenges

Table 2 Metaverse-based interventions in psychiatric disorders: Examples

Ref.	Study	Findings
Yellowlees and Cook[28], 2006	Pilot study using the Second Life metaverse platform to simulate auditory and visual hallucinations of patients with schizophrenia. Five hundred seventy-nine users competed the tour and recorded their responses	The majority of users reported that the virtual tour improved their understanding of hallucinations and that they would recommend it for others
Hoch et al[29], 2012	Mindfulness and relaxation-based resiliency training using the Second Life metaverse platform in 24 healthy participants	The intervention was feasible and acceptable to the participants. It led to reduction in stress, depression, and anxiety. The effects were comparable to in-person interventions
Yuen et al[30], 2013	Feasibility, acceptability, and efficacy of an acceptance-based therapy using the Second Life metaverse platform in 14 people with social anxiety disorder	Participants and therapists rated the intervention as feasible and acceptable. The intervention led to improvements in social anxiety, depression, disability, and quality of life
Matsangidou et al[31], 2022	Feasibility trial of a “Multi-User Virtual Reality”-based remote psychotherapy in 13 participants with eating disorders	Feasibility, acceptability, and the usefulness of the application was demonstrated. High levels of immersion and sense of presence were the key to success
Lee et al[32], 2023	Open-label, single-center, pilot parallel randomized controlled trial of 15 children with high-functioning autistic spectrum disorder. Treatment consisted of a metaverse-based social skills intervention delivered via the metaverse platforms (Roblox) and Zoom	The intervention was significantly more effective than the control treatment in improving social interaction, social cognition, social communication, and autistic mannerisms. The intervention enhanced mental health, reduced emotional and behavioral problems in children, and distress among parents
Vila et al[33], 2024	Randomized controlled trial of avatar-based psychotherapy using the Second Life metaverse platform in 31 women with female orgasmic disorder. The intervention consisted of 12 weekly sessions based on cognitive behavioral and acceptance and commitment therapy	Compared to the control group, participants in the avatar-based intervention showed a significant improvement in reduction of a sexual disorder diagnosis, improved sexual satisfaction, sexual function, initiative and sexual communication, and sexual self-esteem, reduced guilt about sex, and sexual anxiety, and enhanced adherence
Vila et al[34], 2024	Qualitative analysis of attitudes to metaverse-based psychotherapy for psychiatric and sexual disorders among 21 participants of either gender	Attitudes towards metaverse-based treatment were favorable for both psychiatric and sexual disorders. The main reason was improved access to psychological treatments through the metaverse