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Effectiveness of Virtual Reality Therapy in Alcohol Use Disorder Study

Not Applicable
Recruiting
Conditions
Alcool Use Disorder
Interventions
Behavioral: CBT in group
Behavioral: individual CBT
Other: Virtual reality exposure
Registration Number
NCT06104176
Lead Sponsor
Assistance Publique - Hôpitaux de Paris
Brief Summary

Intro: Virtual reality exposure therapy (VRET) has been widely assessed in several mental disorders, including substances use disorders. In the case of alcohol use disorder (AUD), published studies focus mainly on craving interventions: eliciting, triggering, reduction or extinction, with promising result. However, data Virtual reality exposure therapy effect on reduction of alcohol consumption or abstinence remains scarce.

Hypothesis/Objective: The investigators hypothesis that VRET associated to cognitive behaviors therapy (CBT) will be more effective than CBT alone on the reduction in the cumulative number of standard drinks (vs) of alcohol intakes at 8 months after inclusion. The second objective is the assess its effectiveness on reported craving also at 8 months.

Method: The investigators plane to recruit 156 subjects aged 18 and over, with AUD according to DSM V criteria, abstinent for at least 15 days. Non-inclusion criteria are: AUD relapse, pregnancy or breastfeeding (for women), decompensated comorbid mental disorder, severe cognitive impairment, epilepsy or history of photo paroxysmal EEG responses, balance disorders, recent stroke less than 3 months old, current nausea/vomiting, claustrophobia, severe visual impairment, and medium or high myopia (beyond -3.5 diopters). The study recruitment and sitting will be on 4 addiction day hospitals, and the follow up period will be of 8 months.

All subjects will have 4 sessions of group CBT (one per week) during the first month following their inclusion, and then randomly assigned (ratio 1:1) to VRET group or individual CBT group. Subjects will undergo 4 additional sessions of VRET or individual CBT (one per week) during the second month. Afterwards, all included subjects will be followed monthly for 6 months (Months 2 to 8 after inclusion). Timeline Follow-Back (TLFB) is used for the reporting of the number of alcohol standard drinks intakes, and the Transaddiction Craving Triggers Questionnaire (TCTQ) for craving assessment.

Detailed Description

Not available

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
156
Inclusion Criteria
  • Aged 18 or over, and under 80 on the date of inclusion
  • Fulfilling Alcohol use disorder according to the DSM-V criteria (American Psychiatric Association, 2013);
  • In alcohol abstinence for at least 15 days;
  • Be able to speak, understand and read French;
  • Signed an informed consent
  • Affiliated to the French health insurance scheme
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Exclusion Criteria
  • • Major under legal protection measure, or deprived of liberty by judicial or administrative decision;

    • Pregnant or breastfeeding women;
    • Decompensated psychiatric disoreder (psychotic disorders, mood disorders and anxiety disorders);
    • Alcohol use disorder relapse
    • Severe cognitive impairment as defined by a score of 10 or less at the Montreal Cognitive Assessment (MOCA) (Nasreddine et al., 2005)
    • Visual impairment
    • Contraindications to virtual reality exposure: a history of photosensitive epilepsy, response, balance disorders, recent stroke less than 3 months old, current nausea/vomiting, claustrophobia, and medium or high myopia (beyond -3.5 diopters)
    • Patients wearing one of the following medical devices (due to the risk of interference of the virtual reality headset with them): pacemaker, implanted defibrillator, or implanted hearing aids (non-implanted prostheses are not contraindicated if the patient agrees to remove them during virtual reality exposure)
    • Participation in another trial or being in the exclusion period following previous research involving humans, if applicable
    • Patients not affiliated to the French health insurance scheme and receiving the State Medical Aid
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Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
CBT groupindividual CBT-
VRET groupCBT in group-
VRET groupVirtual reality exposure-
CBT groupCBT in group-
Primary Outcome Measures
NameTimeMethod
Cumulative number of alcohol standard drinksmonthly until 8 months after inclusion

Cumulative number of alcohol standard drinks 8 months after inclusion assessed by the Timeline Follow-Back method (Sobell \& Sobell, 1992).

Secondary Outcome Measures
NameTimeMethod
frequency of alcohol hazardous drinksat inclusion, 2, 5 and 8 months after inclusion

the frequency is assessed by the Alcohol Use Disorders Identification Test (AUDIT-C) (Bush et al., 1998)

Self-efficacyat inclusion, 2, 5 and 8 months after inclusion

Self-efficacy is assessed by Self-efficacy Questionnaire (Jerusalem \& Schwarzer, 1992).

Cybersicknessat inclusion, 2, 5 and 8 months after inclusion

Cybersickness symptoms are assessed by the Simulator Sickness Questionnaire (Kennedy et al., 1993)

Repetitive thinkingat inclusion, 2, 5 and 8 months after inclusion

Repetitive negative thinking is assessed by the The Perseverative Thinking Questionnaire (PTQ) en (Devynck et al, 2017)

Virtual environment presenceat inclusion, 2, 5 and 8 months after inclusion

Virtual environment presence is assessed by the presence questionnaire (Witmer et al.2005)

Cravingat inclusion, 2, 5 and 8 months after inclusion

Level of reported craving assessed by the Transaddiction Craving Triggers Questionnaire (von Hammerstein et al., 2020) and by a Visual Analogue Scale (from 0 to 10) (Drobes \& Thomas, 1999).

Anxiety levelat inclusion, 2, 5 and 8 months after inclusion

Anxiety level is assessed by the (Generalized Anxiety Disorder-7) (Spitzer et al., 2006)

Depression severityat inclusion, 2, 5 and 8 months after inclusion

Depression symptoms severity are assessed by the Patient Health Questionnaire 9) (Kroenke et al., 2001).

Trial Locations

Locations (1)

Hôpital Albert Chenevier

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Créteil, Ile-De-France, France

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