Improvement in social competence in patients with schizophrenia: A pilot study using a performance-based measure using virtual reality

Objective: The objective of this study was to explore the possibility of the use of Virtual Reality Functional Skills Assessment (VRFSA) in a future regular clinical trial, as well as to report a preliminary result about effectiveness of atypical antipsychotics to social competence in schizophrenia. Methods: We developed the VRFSA that measured subjects' performances automatically and used analogue scale rather than Likert scale. Twenty-four female patients with paranoid schizophrenia and 15 healthy females were recruited. This was a 6-week, randomized, open-label, and flexible dose study, and 2 treatments (baseline versus post-treatment) x 2 skills phases (receptive versus expressive) x 2 patient groups (aripiprazole versus risperidone) analysis of variance was used in the final analysis. Results: There was a significant difference in the VRFAS between the patients and the healthy subjects (p<0.05). Eighteen patients were included in the final analysis. We found larger treatment effect than those found in previous studies, and significant treatment x skills phase x group interaction effect on the VRFAS. Conclusions: Our results suggest that the VRFAS is strongly sensitive to changes in social competence and thus especially beneficial in short-term clinical trials. In addition, atypical antipsychotics can improve social competence and differentially improve receptive skills and expressive skills in schizophrenia.