A virtual perspective on OCD: Virtual reality in the assessment of obsessive-compulsive disorder

Patients with obsessive-compulsive disorder (OCD) experience obsessions and compulsions, which cause tremendous suffering. However, they usually do not experience their symptoms in the safety of a clinician’s room. Provoking and observing symptoms of OCD in a consulting room would result in a better diagnosis. The aim of this thesis was to demonstrate if we could use a specifically designed virtual reality (VR) game to assess symptoms of OCD. To this end, we - evaluated the current state-of-the art of using VR in the psychiatric diagnostic process - completed a pilot study and clinical trial to evaluate if the VR-game was able to provoke and assess OCD symptoms and physiologic arousal in patients, as opposed to healthy controls - investigated if the VR-game activated OCD-related brain areas with a pilot study where the VR-game was performed in a MRI scanner - illustrated how OCD symptomatology is affected by developments in modern technology by means of two case reports. We showed that VR can be used to assess psychiatric symptoms such as anxiety, paranoia and hyperactivity. As for our OCD VR-game, we showed that it was possible to provoke and measure anxiety and virtual compulsions in OCD patients as opposed to healthy controls. Furthermore, we showed the VR-game has potential in activating OCD-related brain areas in fMRI symptom provocation. In our discussion we make suggestions for alternative research designs to bring innovation and scientific research closer together