Most Read Articles
Stephen Padilla, 23 hours ago
Treatment with oral thrombopoietin receptor agonist eltrombopag leads to similar platelet counts in patients with chronic immune thrombocytopaenia (cITP) and persistent (per)ITP, according to the results of phase III (EXTEND) and IV studies presented at the 23rd Congress of the European Hematology Association (EHA 2018) held in Stockholm, Sweden.
Pearl Toh, 3 days ago
Lonely people were twice as likely to die from any cause than people who did not feel lonely, according to a study based on a national survey presented at the recent EuroHeartCare 2018 in Dublin, Ireland. Also, loneliness is associated with poorer patient-reported outcomes in terms of mental and physical health in patients with heart disease.
6 days ago
Higher activity of plasma xanthine oxidase appears to be linked to insulin resistance and liver dysfunction among type 2 diabetes mellitus (T2DM) patients with metabolic syndrome (MetS), according to a recent Japan study.
15 Jun 2018
Use of quetiapine among critically ill patients rarely leads to corrected QT (QTc) interval prolongation, reports a new study.

AVATAR therapy more effective than supportive counselling for hallucinations

Tristan Manalac
30 Nov 2017

AVATAR therapy is more effective than traditional supportive counselling in lessening the severity of persistent auditory verbal hallucinations, suggesting that brief and targeted approaches may also be effective against psychosis, a recent randomized controlled trial (RCT) has shown.

“AVATAR therapy is a brief therapy for persistent, distressing voices that makes creative and novel use of digital representations of psychotic experiences to provide a controlled but realistic therapeutic encounter, enabling dialogue and change,” the researchers said.

The research team performed a single-blind RCT on 150 schizophrenia spectrum disorder patients with distressing auditory verbal hallucinations for at least 12 months. Participants were randomized to receive either supportive counselling (n=75; mean age 42.9±11.2 years; 60 percent male) or AVATAR therapy (n=75; mean age 42.5±10.1 years; 76 percent male).

During AVATAR therapy, participants first created a digital representation of their hallucinations. The therapist, speaking through the digital avatar, then conducted a dialogue with the patients where the avatar gradually conceded power and acknowledged the good qualities of the participants. The study primary outcome was the change in severity of hallucinations.

After 12 weeks, reductions in auditory hallucinations, as measured by the auditory hallucinations subscale of the Psychotic Symptom Rating Scales, were significantly greater in patients who received AVATAR therapy than in those who received traditional supportive counselling (adjusted mean difference [MD], -3.82; 95 percent CI -6.70 to -0.94; p=0.009). [Lancet Psychiatry 2017;doi:10.1016/S2215-0366(17)30427-3]

AVATAR therapy also resulted in significantly greater 12-week improvements in the frequency of hallucinations (adjusted MD, -1.22; -1.97 to -0.48; p=0.0013) and patient distress (adjusted MD, -2.34; -4.26 to -0.42; p=0.017).

At the 12-week follow-up, nine participants reported complete absence of hallucinations, of whom seven belonged to the AVATAR group and two to the supportive counselling group. The number who reported the same absence increased to 14 participants (eight in the AVATAR and six in the supportive counselling groups) after 24 weeks.

Aside from the confirmation of the primary outcomes, the study largely supported the “second and third hypotheses … in that AVATAR therapy had a positive and significant on omnipotence, and that these positive effects on voices were sustained at 24 weeks,” researchers said.

In contrast, AVATAR therapy had no impact on the malevolence of the voices.

Overall, “AVATAR therapy was feasible to deliver, acceptable to participants, and did not result in any adverse events that could be attributed to the therapy. The study corroborated the primary hypothesis concerning clinical efficacy by showing a rapid and sustained reduction in the severity of auditory verbal hallucinations by end of therapy,” the researchers said.

Digital Edition
Asia's trusted medical magazine for healthcare professionals. Get your MIMS Psychiatry - Malaysia digital copy today!
Sign In To Download
Editor's Recommendations
Most Read Articles
Stephen Padilla, 23 hours ago
Treatment with oral thrombopoietin receptor agonist eltrombopag leads to similar platelet counts in patients with chronic immune thrombocytopaenia (cITP) and persistent (per)ITP, according to the results of phase III (EXTEND) and IV studies presented at the 23rd Congress of the European Hematology Association (EHA 2018) held in Stockholm, Sweden.
Pearl Toh, 3 days ago
Lonely people were twice as likely to die from any cause than people who did not feel lonely, according to a study based on a national survey presented at the recent EuroHeartCare 2018 in Dublin, Ireland. Also, loneliness is associated with poorer patient-reported outcomes in terms of mental and physical health in patients with heart disease.
6 days ago
Higher activity of plasma xanthine oxidase appears to be linked to insulin resistance and liver dysfunction among type 2 diabetes mellitus (T2DM) patients with metabolic syndrome (MetS), according to a recent Japan study.
15 Jun 2018
Use of quetiapine among critically ill patients rarely leads to corrected QT (QTc) interval prolongation, reports a new study.