Extended Reality(XR) enhanced behavioral activation for treatment of Major Depressive Disorder

Abstract

Depression is a major public health problem associated with increased functional disability and mortality. In the United States in 2010, the estimated annual economic consequences of unipolar major depression, including direct medical costs and workplace costs, exceeded 200 billion dollars. Major Depressive Disorder (MDD) is estimated to be the 11th leading cause of disability and mortality worldwide. Depressive disorders are a global crisis with increasing incidence and prevalence which have been exacerbated by the COVID-19 pandemic. Numerous well established evidence-based psychotherapies (EBPs) have been developed to treat depression effectively. Unfortunately, for those with MDD who reach out for help it is estimated that only 37.5 percent receive minimally adequate treatment or an EBP. One of the simplest and most effective EBP’s is Behavioral Activation (BA) and it can easily be taught to and delivered by primary care providers. However, there are many barriers to accessing, disseminating, and scaling EBP’s for MDD. Extended Reality (XR) technologies are well positioned to address and eliminate these barriers especially for BA. To accelerate the development of XR in EBP delivery, we have created a simple XR enhanced BA and established its feasibility in a small pilot study. In order to scale this XR-BA technology we are proposing a small randomized controlled efficacy trial and a rapid deployment-focused model to test scalability. If successful, it would allow creation of a startup or licensing agreements with existing companies.