Virtual reality for psycho-education on self-stigma in depression: Design of a randomised controlled trial

Background: Major Depressive Disorder (MDD) is a prevalent and disabling mental health condition. Patients with MDD often deal with self-stigma, which can lead to more depressive symptoms. Psychoeducation about depression has proven to be effective in reducing depressive symptomatology and self-stigma. Involving a significant other in psychoeducation for depression, might increase mutual understanding. Virtual reality (VR) offers the opportunity to experience the perspective of having or living with someone with a mental condition. For this study an immersive VR environment is developed. The main objective of this study is to test whether our VR psychoeducation intervention is more successful in reducing self-stigma than standard psychoeducation for MDD. Methods: In this randomised controlled trial (RCT), 80 couples of patients and their significant other will be included and randomly assigned to one of two conditions: the VR psychoeducation intervention and standard psychoeducation. Patients will be aged 18 to 65, diagnosed with MDD. The main study parameter is self-stigma, as measured by the Internalized Stigma of Mental Illness scale. Secondary parameters include depressive symptoms, loneliness and perceived social support for the patient and burden of care and quality of life for the significant other. Limitations: No control for nonspecific factors, limited individual adjustment, patients are not able to participate without a significant other. Conclusions: VR might open up the opportunity to reduce self-stigma and thereby improve the efficacy of psychoeducation in MDD.