Virtual Reality Tool Assesses Functional Capacity in Early Schizophrenia

man with virtual reality goggles on
man with virtual reality goggles on
Researchers found data that showed young patients in the early phase of schizophrenia would benefit by the Virtual Reality Functional Capacity Assessment Tool, as a measure to track changes in response to treatment.

The Virtual Reality Functional Capacity Assessment Tool (VRFCAT) appears to be a valid tool for evaluating cognitive functioning in young patients with first-episode schizophrenia, according to research published in Early Intervention in Psychiatry.

A cross-sectional study was conducted to validate the use of the VRFCAT against the University of California, San Diego (UCSD), Performance-Based Skills Assessment-2 as an accurate means of measuring functional capacity in these patients. The UCSD Performance-Based Skills Assessment-2 is a paper-and-pencil tool that measures functional capacity; the VRFCAT is a computer-based tool that simulates scenarios to measure functional capacity. The MATRICS Consensus Cognitive Battery and the cognitive assessment interview were also used to assess cognitive functioning, and the global functioning scale-role, global functional scale-social, and Role Functioning Scale were used to assess functional outcomes.

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The study included 42 patients with first-episode schizophrenia and 13 healthy controls who were comparable in age, race, and ethnicity. The initial onset of psychosis for each participant occurred within 2 years of the study, and each met the criteria for either schizophrenia, schizoaffective disorder depressed type, or schizophreniform disorder. The schizophrenia arm contained more women and the control cohort attained a higher mean level of education (P =.01 for both).

When assessing the differences between the 2 cohorts, the VRFCAT demonstrated that the schizophrenia cohort completed the assessment more slowly than the controls (t=3.0; P <.01) and made more errors when completing the assessment (t=2.9; P <.01).

A comparison of the VRFCAT with the functional capacity and cognitive functioning assessments indicated that the VRFCAT scores were significantly correlated with the UCSD Performance-Based Skills Assessment-2, the MATRICS Consensus Cognitive Battery, and the Cognitive Assessment Interview (P <.01). Specifically, the VRFCAT’s total completion time was significantly correlated with the UCSD Performance-Based Skills Assessment-2 evaluations of occupational and school functioning score and the social functioning score. This significant correlation is an indicator that the VRFCAT is a valid tool for measuring functional capacity.

Limitations of this study include the small sample size, the gender imbalance, and the inability of this cross-sectional study to assess changes over time.

The researchers concluded that “[v]irtual-reality–based performance was correlated with a standard test of functional capacity, indicating [Virtual Reality Functional Capacity Assessment Tool] validity” for patients in the early phase of schizophrenia. However, they recommended further research “to more directly establish that changes in the [Virtual Reality Functional Capacity Assessment Tool] are related to changes in cognition and everyday functioning.”

Several authors report multiple associations with pharmaceutical companies and professional organizations. One author receives royalties from the MATRICS Battery and the Virtual Reality Functional Capacity Assessment Tool. Please see the original reference for a full list of authors’ disclosures.

Ventura J, Welikson T, Ered A, et al. Virtual reality assessment of functional capacity in the early course of schizophrenia: Associations with cognitive performance and daily functioning [published online June 10, 2019]. Early Interv Psychiatry. doi: 10.1111/eip.12831