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Nature Experience-based Virtual Reality Improves Depressive Symptoms in a Young Population: A Pilot Study

  • Da-Been Lee (Department of Health and Safety Convergence Science, Graduate School, Korea University) ;
  • Seung-Lim Yoo (Sleep Medicine Institute, Jungwon University) ;
  • Sang Shin Pyo (Department of Biomedical Laboratory Science, Shinhan University) ;
  • Jinkwan Kim (Sleep Medicine Institute, Jungwon University) ;
  • Bo-Gyu Kim (Department of Theater and Film, Jungwon University) ;
  • Suhng-Wook Kim (Department of Health and Safety Convergence Science, Graduate School, Korea University) ;
  • Byung-Jung Ko (Department of Theater and Film, Jungwon University) ;
  • Dae Wui Yoon (Sleep Medicine Institute, Jungwon University)
  • 투고 : 2024.02.05
  • 심사 : 2024.03.05
  • 발행 : 2024.03.31

초록

Although there have been several attempts to use virtual reality (VR) in the treatment of depression, the results have been inconsistent and existing studies have mostly relied on subjective measures to assess the effectiveness of VR in improving depression. The aim of this study was to investigate the effect of nature experience-based VR intervention on depressive symptoms in a young population using both subjective and objective measurements. The study population included 15 participants who had more than 14 identifiers of the Korean Beck Depression Inventory (K-BDI)-II. Participants received three weeks (four times per week) of VR intervention. The effectiveness of VR was assessed through changes in K-BDI-II scores and depression-related blood biomarkers. Nature experience-based VR intervention led to an approximately 50% reduction of K-BDI-II score (before 25.7±7.7 vs. after 12.5±8.3 (P<0.001)). Of these, loss of pleasure and fatigue showed the largest amount of improvement. However, levels of cortisol, brain-derived neurotrophic factor, and interleukin-6 did not differ from those at baseline. The findings of our pilot study suggest that nature experience-based VR can be a useful adjunctive treatment method for improving depressive symptoms in individuals who have difficulty accessing the real outside natural environment.

키워드

과제정보

The authors thank Ms. Hee-Jeong Joo, Ji-Yoon Kwak, Da-In Kim for assisting study procedures. This research was supported by "Regional Innovation Strategy (RIS)" through the National Research Foundation of Korea (NRF) funded by the Ministry of Education (MOE) (2021RIS-001).

참고문헌

  1. Ames SL, Wolffsohn JS, McBrien NA. The development of a symptom questionnaire for assessing virtual reality viewing using a head-mounted display. Optom Vis Sci. 2005. 82: 168-176. 
  2. Bratman GN, Hamilton JP, Daily GC. The impacts of nature experience on human cognitive function and mental health. Ann N Y Acad Sci. 2012. 1249: 118-136. 
  3. Bratman G, Daily G, Levy B, Gross J. The benefits of nature experience: Improved affect and cognition. Landscape and Urban Planning. 2015. 138: 41-50. 
  4. Beevers CG, Pearson R, Hoffman JS, Foulser AA, Shumake J, Meyer B. Effectiveness of an internet intervention (Deprexis) for depression in a united states adult sample: A parallel-group pragmatic randomized controlled trial. J Consult Clin Psychol. 2017. 85: 367-380. 
  5. Carl E, Stein AT, Levihn-Coon A, Pogue JR, Rothbaum B, Emmelkamp P, Asmundson GJG, Carlbring P, Powers MB. Virtual reality exposure therapy for anxiety and related disorders: A meta-analysis of randomized controlled trials. J Anxiety Disord. 2019. 61: 27-36. 
  6. Carnegie K, Rhee T. Reducing Visual Discomfort with HMDs Using Dynamic Depth of Field. IEEE Comput Graph Appl. 2015. 35: 34-41. 
  7. Carvalho AL, Caldeira MV, Santos SD, Duarte CB. Role of the brain-derived neurotrophic factor at glutamatergic synapses. Br J Pharmacol. 2008. 153(Suppl 1): S310-324. 
  8. Chen W, Chao JG, Chen XW, Wang JK, Tan C. Quantitative orientation preference and susceptibility to space motion sickness simulated in a virtual reality environment. Brain Res Bull. 2015. 113: 17-26. 
  9. Dehn LB, Kater L, Piefke M, Botsch M, Driessen M, Beblo T. Training in a comprehensive everyday-like virtual reality environment compared to computerized cognitive training for patients with depression. Computers in Human Behavior. 2018. 79: 40-52. 
  10. Dowlati Y, Herrmann N, Swardfager W, Liu H, Sham L, Reim EK, Lanctot K. A meta-analysis of cytokines in major depression. Biol Psychiatry. 2010. 67: 446-457. 
  11. Furman E, Jasinevicius TR, Bissada NF, Victoroff KZ, Skillicorn R, Buchner M. Virtual reality distraction for pain control during periodontal scaling and root planing procedures. J Am Dent Assoc. 2009. 140: 1508-1516. 
  12. Garcia-Palacios A, Hoffman H, Carlin A, Furness TA, 3rd, Botella C. Virtual reality in the treatment of spider phobia: a controlled study. Behav Res Ther. 2002. 40: 983-993. 
  13. Hannestad J, DellaGioia N, Bloch M. The effect of antidepressant medication treatment on serum levels of inflammatory cytokines: a meta-analysis. Neuropsychopharmacology. 2011. 36: 2452-2459. 
  14. Ioannou A, Papastavrou E, Avraamides MN, Charalambous A. Virtual Reality and Symptoms Management of Anxiety, Depression, Fatigue, and Pain: A Systematic Review. SAGE Open Nurs. 2020. 6: 2377960820936163. 
  15. Jani BD, McLean G, Nicholl BI, Barry SJ, Sattar N, Mair FS, Cavanagh J. Risk assessment and predicting outcomes in patients with depressive symptoms: a review of potential role of peripheral blood based biomarkers. Front Hum Neurosci. 2015. 9: 18. 
  16. Karege F, Perret G, Bondolfi G, Schwald M, Bertschy G, Aubry JM. Decreased serum brain-derived neurotrophic factor levels in major depressed patients. Psychiatry Res. 2002. 109: 143-148. 
  17. Malhi GS, Mann JJ. Depression. Lancet. 2018. 392: 2299-2312.
  18. Martinowich K, Lu B. Interaction between BDNF and serotonin: role in mood disorders. Neuropsychopharmacology. 2008. 33: 73-83. 
  19. McLay RN, Graap K, Spira J, Perlman K, Johnston S, Rothbaum BO, Difede J, Deal W, Oliver D, Baird A, Bordnick PS, Spitalnick J, Pyne JM, Rizzo A. Development and testing of virtual reality exposure therapy for post-traumatic stress disorder in active duty service members who served in Iraq and Afghanistan. Mil Med. 2012. 177: 635-642. 
  20. Mittelstaedt JM. Individual predictors of the susceptibility for motion-related sickness: A systematic review. J Vestib Res. 2020. 30: 165-193. 
  21. Mosso JL, Gorini A, De La Cerda G, Obrador T, Almazan A, Mosso D, Nieto JJ, Riva G. Virtual reality on mobile phones to reduce anxiety in outpatient surgery. Stud Health Technol Inform. 2009. 142: 195-200. 
  22. Ohyama S, Nishiike S, Watanabe H, Matsuoka K, Akizuki H, Takeda N, Harada T. Autonomic responses during motion sickness induced by virtual reality. Auris Nasus Larynx. 2007. 34: 303-306. 
  23. Opris D, Pintea S, Garcia-Palacios A, Botella C, Szamoskozi S, David D. Virtual reality exposure therapy in anxiety disorders: a quantitative meta-analysis. Depress Anxiety. 2012. 29: 85-93. 
  24. Park KM, Ku J, Choi SH, Jang HJ, Park JY, Kim SI, Kim JJ. A virtual reality application in role-plays of social skills training for schizophrenia: a randomized, controlled trial. Psychiatry Res. 2011. 189: 166-172. 
  25. Park MJ, Kim DJ, Lee U, Na EJ, Jeon HJ. A Literature Overview of Virtual Reality (VR) in Treatment of Psychiatric Disorders: Recent Advances and Limitations. Front Psychiatry. 2019. 10: 505. 
  26. Radloff LS. The CES-D Scale: A Self-Report Depression Scale for Research in the General Population. Applied Psychological Measurement. 1977. 1: 385-401. 
  27. Reichardt LF. Neurotrophin-regulated signalling pathways. Philos Trans R Soc Lond B Biol Sci. 2006. 361: 1545-1564. 
  28. Scates D, Dickinson JI, Sullivan K, Cline H, Balaraman R. Using Nature-Inspired Virtual Reality as a Distraction to Reduce Stress and Pain Among Cancer Patients. Environment and Behavior. 2020. 52: 895-918. 
  29. Segal ZV, Whitney DK, Lam RW. Clinical guidelines for the treatment of depressive disorders. III. Psychotherapy. Can J Psychiatry. 2001. 46(Suppl 1): 29s-37s. 
  30. Steer RA, Clark DA, Beck AT, Ranieri WF. Common and specific dimensions of self-reported anxiety and depression: the BDIII versus the BDI-IA. Behav Res Ther. 1999. 37: 183-190. 
  31. Strawbridge R, Arnone D, Danese A, Papadopoulos A, Herane Vives A, Cleare AJ. Inflammation and clinical response to treatment in depression: A meta-analysis. Eur Neuropsychopharmacol. 2015. 25: 1532-1543. 
  32. Strawbridge R, Young AH, Cleare AJ. Biomarkers for depression: recent insights, current challenges and future prospects. Neuropsychiatr Dis Treat. 2017. 13: 1245-1262. 
  33. Strunk KK, Lane FC. The Beck Depression Inventory, Second Edition (BDI-II): A Cross-Sample Structural Analysis. Measurement and Evaluation in Counseling and Development. 2017. doi: 10.1080/0781756.2017.1318636. 
  34. Sung HM, Kim JB, Park YN, Bai Daiseg, Lee SH, Ahn HN. A study on the reliability and the validity of Korean version of the Beck Depression Inventory-II (BDI-II). J Korean Soc Biol Ther Psychiatry. 2008. 14: 201-212. 
  35. Sutcigil L, Oktenli C, Musabak U, Bozkurt A, Cansever A, Uzun O, Sanisoglu SY, Yesilova Z, Ozmenler N, Ozsahin A, Seugul A. Pro- and anti-inflammatory cytokine balance in major depression: effect of sertraline therapy. Clin Dev Immunol. 2007. 2007: 76396. 
  36. Ulrich RS. Natural versus urban scenes: Some psychophysiological effects. Environment and Behavior. 1981. 13: 523-556. 
  37. Wallach HS, Bar-Zvi M. Virtual-reality-assisted treatment of flight phobia. Isr J Psychiatry Relat Sci. 2007. 44: 29-32. 
  38. Willner P, Scheel-Kruger J, Belzung C. The neurobiology of depression and antidepressant action. Neurosci Biobehav Rev. 2013. 37: 2331-2371. 
  39. World Health Organization. Depression and other common mental disorders: global health estimates [Internet]. Available at: https://apps.who.int/iris/handle/10665/254610. Accessed October 14, 2022. 
  40. World Health Organization. Practice guideline for the treatment of patients with major depressive disorder (revision). American Psychiatric Association. Am J Psychiatry. 2000. 157: 1-45. 
  41. Yang JE, Lee TY, Kim JK. The effect of a VR exercise program on falls and depression in the elderly with mild depression in the local community. J Phys Ther Sci. 2017. 29: 2157-2159. 
  42. Yesavage JA, Brink TL, Rose TL, Lum O, Huang V, Adey M, Leirer VO. Development and validation of a geriatric depression screening scale: a preliminary report. J Psychiatr Res. 1982. 17: 37-49.