The meta-analysis by Zeng et al. (2025), published in Frontiers in Psychiatry, examines the effectiveness of virtual reality therapy (VRT) in treating anxiety disorders in adolescents and adults. A total of 33 randomized controlled trials involving 3,182 participants from 18 countries were included. The main finding: VRT leads to a significant reduction in anxiety symptoms compared to traditional methods (SMD = -0.95; 95% confidence interval: -1.22 to -0.69; p < 0.00001).
The effect was particularly pronounced in cases of perioperative anxiety (e.g., before surgeries), perinatal anxiety (around pregnancy and childbirth), as well as exam or test-related anxiety. Subgroup analyses show that Virtual Reality Exposure Therapy (VRET), which involves targeted confrontation with anxiety-inducing stimuli in a virtual environment, was more effective than mere distraction through relaxing VR content.
However, many of the studies have methodological weaknesses: Almost half had a high risk of bias, and the heterogeneity of the results was large (I² = 91%). Differences in VR technology, duration, target groups, and assessment scales may have influenced the results. The authors therefore recommend further research with larger sample sizes, standardized procedures, and physiological measurement data (e.g., heart rate or EEG). Side effects such as nausea, dizziness, and eye strain have been reported, but they occurred only in a portion of the users. Long-term effects are still insufficiently studied.
Fazit
Despite limitations, VRT is a promising addition to traditional anxiety therapy – especially in situations where real exposure is difficult or impossible. In the future, low-threshold VR applications with therapeutic support could reach broader target groups.
Liturature: www.frontiersin.org/journals/psychiatry/articles/10.3389/fpsyt.2025.1553290/full
