- Randomised controlled trial evaluating a VR protocol simulating auditory, visual hallucinations and persecutory delusions to reduce stigma among healthcare workers and students.
- Primary outcome is reduction in AQ-27 stigma score from baseline to one month, comparing intervention and control; expected greater reduction with VR.
- Explicit stigma assessed with AQ-27, Reported and Intended Behaviour Scale and Community Attitudes toward the Mentally Ill; implicit stigma measured by the Implicit Association Test; 128 participants, ethics approved.
BMJ Open. 2026 Aug 5;16(8):e111884. doi: 10.1136/bmjopen-2025-111884.
ABSTRACT
INTRODUCTION: Schizophrenia is a chronic psychiatric disorder, frequently associated with stigma, including within healthcare settings that significantly impairs quality of life and may exacerbate symptoms. Virtual reality (VR), as an immersive tool, may allow healthy individuals to experience the first-person perspective of a patient experiencing psychotic symptoms. VR exposure may facilitate perspective-taking, foster empathy and help reduce stigma. However, the findings remain incomplete, with considerable variation between protocols and no data on implicit stigma. Here, we present a study designed to evaluate the effectiveness of a VR protocol simulating psychotic symptoms on explicit and implicit stigma.
METHODS AND ANALYSIS: A randomised controlled trial will be conducted targeting a sample size of 128 evaluable participants. Participants will include healthcare workers and students (medicine, nursing or psychology) recruited from CH Henri Laborit in Poitiers (France), Poitiers University Hospital, CH Nord-Deux-Sèvres in Thouars (France) and the University of Poitiers. Recruitment will take place over a 2-year period. Participants will be randomly assigned to either the intervention group or the control group.The protocol involves two short VR scenarios. In the intervention condition only, both scenarios will simulate auditory and visual hallucinations and persecutory delusions, immersing participants in the experience of someone living with schizophrenia. Stigma will be assessed before the VR intervention, immediately afterward and at 1-month follow-up. Assessment will be conducted using self-report scales (Attribution Questionnaire-27 (AQ-27), Reported and Intended Behaviour Scale and Community Attitudes toward the Mentally Ill scale) for explicit stigma and a behavioural test, Implicit Association Test, for implicit stigma.The primary outcome is the reduction in stigma toward individuals with schizophrenia, assessed with the AQ-27 scale, from baseline to the 1-month follow-up, comparing the intervention and control groups. The expected result is a greater reduction in stigma in the intervention group compared with the control group. Secondary outcomes include changes in implicit associations at 1-month follow-up, immediate post-intervention effects on stigma and changes in self-reported prejudice and discrimination over time.
ETHICS AND DISSEMINATION: All participants receive both oral and written information and will provide signed informed consent. The study has been approved by the French Research Ethics Committee (reference number: 2025-A01472-47, Comité de Protection des Personnes Ile-de-France III, Paris, France, approval date: 22 May 2026).Results will be disseminated through presentations, conferences and publications in peer-reviewed scientific journals.
TRIAL REGISTRATION NUMBER: NCT07375199.
PMID:42556844 | DOI:10.1136/bmjopen-2025-111884
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