Comparison of the Effectiveness Level of Virtual Reality Exposure Therapy With Sertraline Treatment in Social Anxiety Disorder

Social anxiety disorder (SAD) is a common psychiatric condition that often begins in adolescence and causes significant impairment in academic, social, and occupational functioning. Although selective serotonin reuptake inhibitors (SSRIs) such as sertraline have demonstrated efficacy, many families and patients hesitate to use pharmacological treatments due to concerns about side effects and personal preferences. Virtual reality (VR)-based exposure therapy has emerged as a promising intervention by providing controlled and immersive environments where social situations can be simulated safely.

This study is designed to evaluate the effectiveness of VR exposure therapy compared with sertraline in adolescents and young adults diagnosed with SAD. Participants (N = 56) will be allocated to either VR therapy or sertraline treatment depending on treatment preference. The primary outcome will be reduction in social anxiety symptoms assessed with standardized clinical scales. Secondary outcomes will include functional improvements, treatment acceptability, and safety assessments.

The trial is conducted at Kocaeli University, Department of Child and Adolescent Psychiatry, and aims to provide evidence regarding whether VR exposure therapy can serve as an effective and acceptable alternative to pharmacological treatment in this population.

Inclusion criteria

• RESEARCH ARM:

• Applied to Kocaeli University Child and Adolescent Psychiatry Outpatient Clinic
• Have normal intelligence based on clinical observation
• Be between 12 and 17 years of age
• Have a diagnosis of SAD
• Have refused medication recommended for SAD
• For SAD; are not currently receiving medical treatment
• Have received written consent to participate in the study from them and/or their first-degree relatives authorized to make decisions about them
• Have volunteered to participate in the study through an invitation poster presentation

CONTROL ARM:

1 Applied to Kocaeli University Child and Adolescent Psychiatry Outpatient Clinic 2. Have normal intelligence based on clinical observation 3. Be between 12 and 17 years of age 4. Have a diagnosis of SAD 5. Have refused medication recommended for SAD 6. For SAD; are not currently receiving medical treatment 7. Have obtained written informed consent to participate in the study from them and/or their first-degree relatives authorized to make decisions about them 8. Have volunteered to participate in the study through an invitation poster presentation

CONTROL ARM:

1 Applied to Kocaeli University Child and Adolescent Psychiatry Outpatient Clinic 2. Have normal intelligence based on clinical observation 3. Be between 12 and 17 years of age 4. Have a diagnosis of SAD 5. For SAD; Not currently receiving medical treatment 6. Volunteer 7. Written consent for participation in the study must be obtained from the patient and/or their first-degree relative authorized to make decisions about them.

• Accept sertraline treatment, routinely used in outpatient clinic follow-ups for SAD, and volunteer for the study.

Exclusion criteria

RESEARCH ARM:

• Substance use disorder
• Schizophrenia and bipolar disorder
• Autism spectrum disorder
• Cognitive disability
• Neurological disorder
• Balance disorder
• Patients who have received SSRI treatment for SAD in the last 6 months

CONTROL ARM:

• Substance use disorder
• Schizophrenia and bipolar disorder
• Autism spectrum disorder
• Cognitive disability
• Patients who have received SSRI treatment for SAD within the last 6 months -