Introduction of schizophrenia

• Schizophrenia is a mental disorder that generally appears in late adolescence or early adulthood.

• It is one of many brain diseases that may include delusions, loss of personality (flat affect), confusion, agitation, social withdrawal, psychosis, and bizarre behavior.

DSM criteria for Schizophrenia

A. Characteristic Schizophrenia symptoms: Two (or more) of the following, each present for a significant portion of time during a 1 month period (or less if successfully treated):

1. Delusions

4. Hallucinations

3. Disorganized speech

4. Grossly disorganized or catatonic behavior

5."Negative" symptoms of Schizophrenia (Alogia, inappropriate social skills, social isolation)

B. Social/occupational dysfunction: For a significant portion of the time since the onset of the disturbance, one or more major areas of functioning such as work, interpersonal relations, or self-care are markedly below the level achieved prior to the onset.

C. Duration: Continuous signs of the disturbance persist for at least 6 months. This 6-month period must include at least one month of symptoms.

Treatment

Cognitive behaviour therapy

Antipsychotic

Psichoeducation

Cognitive rehabilitation ->VR app

Brain plasticity theory

Advantages and limitations of the virtual reality• Created by Jaron Lanier

“Stimulations in real time through multiple sensorial channels” Visual Auditory Tactile Olfactory …

Advantages and limitations of the virtual reality• Advantages:

Structuring therapy

Acting feelings that generate freedom

Role-playing

Environment be modification

Positive expectations

Use of humor

Control of the situation

• Limitations:

The environment are difficulty access in vivo

Aversive

Higher degree of confidentiality

Antecedents of Virtual Reality in Schizophrenia

• Executive Functions

• Social Skills

• Adherence to Treatment

• Hallucinations and delusions

• Water Task

The VR applicationo a kitchen, to try improving the rehabilitation area of schizophrenia treatment.

o interaction, communication, concentration, memory and perception are activated.

o Social skills and executive functions

The goals• Interaction with other people• Improve social skills• Improve executive functions like attention, memory, information process by cookingrecipes.• Improve autonomy by learning cooking.• Improve spatial memory and personal organitation in the kitchen• Will improved therapy adherence because the motivation increase. • Help him to be conscious about his learning process.

Application’s characteristics• Six tables distributed by the class with a variety of kitchen objects• Four windows• Ahead of the class there is a blackboard• Class behind there is a closet with more kitchen tools, a shelf with books containing recipes of cuisines, and a shelf with the patient's own diaries• The walls will be painted white, but the colour can be changed according to the patient's mood• The external environment may also vary; where patients will see a forest, a city or a village.

Items that can vary according to patient characteristics

• Social skill is one of the difficulties of this patients personal diary- functions: - write down his cooking successes - write his emotions,thoughts, moods• The wall colour changeFor more excitement, the walls will return red or orangeTo sad emotions will return greyTo positive emotions will be light blue or light green• External environment may also vary according to the patient's progress

Interaction between the patient and virtual environment

1. Firstly The patient stay alone (Adaptation).

2. Secondly Appears the teacher (Goals).

3. Thirdly Complain the goals and appear new items.

4. Motivation

5. The goals will complicate

6. Treatment adherence

Conclusions

Advantages

– Support from other virtual reality programs for the treatment of schizophrenia previous:

- VR-Based conversation Training Program for Patients with Schizophrenia: This is a virtual reality is used to solve social skills.

- Pilot Studying of Assessing the Behaviours of Patients with Schizophrenia towards a Virtual Avatar: the behaviour of the avatar and the patient was compared by Positive and Negative Syndrome Scale.

- Water: In this application the patient have to work the spatial memory and orientation

Symptom assessment: The symptom assessment is usually realized between the interviewer and the patient. This evaluation is positive by two reasons:

1. standardized symptoms

2. The progress is more visual to patient

Progressive activity: (Cocking in pairs)

Task

Difficulty

(Cocking alone,

only with the teacher)

• Treatment adherence: We think that Course of kitchen is a creative activity in order to increase the motivation for doing the task and the treatment adherence.

• Better than a real cocking class: The environment of virtual cooking class is better than an ordinary cooking course because this allows patients to have therapist support.

• Social Interaction: We have focused our application using as scenery an interactive social situation, because this kind of situations is the principal context where people’s schizophrenic behaviours are manifested

Limitations (Aspects to improve)

To research: the use of virtual reality interactive immersive computer environments allows one of the key variables in understanding psychosis.

The investigation in the future could consist in the elaboration of a database where were reflected the individual variables of the patients and his reactions in front of every stimulation and situation.

The differential types

Some of this possible variables: The environment types

The genetic types

Global Assessment

Our intention with the virtual cooking class is working with these symptoms, trying to promote: interaction, improving executive functions such as attention, memory, user autonomy, improve self-learn to cook, better memory and spatial orientation, work organization and the patient could be aware of their own learning process.

The application that we have proposed we believe that accomplish the goals we set for ourselves.