Psychiatric hospital in Opava

Opava, 17 May 2024

Patient Z.S.
-10th hospitalization for paranoid schizophrenia.
-Terrain of personality disorder, toxi, mental subnorm.
-He was brought to the current hospitalization by the emergency room at his own request due to vocal hallucinations that urged him to suicidal thoughts.
-Due to suspected substance intoxication, he was assessed as immediately dangerous to himself, and decompensation of the underlying mental disorder could not be ruled out.
-Diagnosis: paranoid schizophrenia, initial intoxication with methamphetamine, THC above 1000

17.4.2024
An introduction to the VR Vitalis® offer and a demonstration.

19.4.2024
Modules: demonstration of each environment and its exploration (loved it!), figure eights, connecting, colours, hanging laundry, chopping, object recognition. The modules selected today lasted quite a short time, and the patient did not complete any of the assignments, even though the module selection was according to his interest and preference.

24.4.20204
The therapy is conducted in a sitting position.Modules: puzzles, free and 3D painting, cups. Today the patient's stamina was a little better than last time, he showed more enthusiasm, but it faded rather quickly and eventually led to loss of interest in the therapy.

25.4.2024
Modules: relaxation, specifically meditation, again chosen independently by the patient. However, he did not like the offer of this module and withdrew from it. He was then offered another option but began to lose interest in anything else. Eventually he tried hanging laundry again, where he was unsuccessful, which eventually led to the termination of therapy.

26.4.2024
Today, the patient has had to force himself into VR therapy extensively. The only thing that convinced him was that he wouldn't have to do anything and would just go through the different environments of the VR menu. During the session, he had his say and chose the wood chopping module in the forest environment. He soon gave up on the therapy, as he had done on previous days.

29.4.2024
Today's therapy session was again brief. For some time our technique was failing, then the patient finally had a therapist personally preset the chopping module he was most interested in. As communication via tablet was failing, we were forced to terminate the therapy.

Conclusion
Patients found working with VR mostly interesting and subjectively had a positive experience with the therapy. Most of all they liked the rich variety of environments that VR offers, the opportunity to see them in detail, to notice details. It was more difficult to complete the tasks. Initial failures in the chosen module quickly led to a loss of interest in the module, and the task was often incomplete. With increasing failures in other modules, interest in the whole VR was often lost. It was necessary to constantly praise and motivate patients to attract their attention.

Author
Lucie Machancová, DiS, Physiotherapist - Head Nurse RHBo, Psychiatric Hospital in Opava

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