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A systematic review and meta-analysis were conducted in accordance with PRISMA guidelines. A thorough literature search was performed across seven databases. Twelve randomized controlled trials involving 1504 participants were included to assess VR-assisted CBT, VR treatment, and AVATAR therapy. Meta-analyses showed that VR interventions significantly decreased auditory verbal hallucinations (pooled SMD = \u22120.24, p = 0.0011) and paranoid thoughts (SMD = \u22120.26, p &lt; 0.0001) compared to control conditions. This review supports integrating multi-modal biosensors to collect real-time, objective physiological data. Such integration enables the development of AI-driven, closed-loop systems that dynamically adjust the virtual environment based on the patient\u2019s physiological state. VR-assisted therapies effectively reduce positive symptoms of psychosis. Incorporating biosensors is a crucial step toward a data-driven approach for personalized, closed-loop psychiatric care. Future efforts should focus on large-scale clinical trials, biomarker validation, and robust ethical frameworks to ensure safe and effective implementation.<\/jats:p>","DOI":"10.3390\/bios16050265","type":"journal-article","created":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T01:12:09Z","timestamp":1777857129000},"page":"265","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Biosensor-Integrated Virtual Reality for Cognitive Behavioral Therapy in Psychosis: A Systematic Review of a New Therapeutic Frontier"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-0580-4989","authenticated-orcid":false,"given":"Aristomenis G.","family":"Alevizopoulos","sequence":"first","affiliation":[{"name":"Department of Psychiatry, Agioi Anargyroi General Oncological Hospital of Kifisia, National and Kapodistrian University of Athens, 14564 Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-0822-3280","authenticated-orcid":false,"given":"Georgios G.","family":"Anastasiou","sequence":"additional","affiliation":[{"name":"BIOSIM Laboratory, School of Electrical and Computer Engineering, National Technical University of Athens, 15780 Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3861-6268","authenticated-orcid":false,"given":"Iakovos","family":"Kritikos","sequence":"additional","affiliation":[{"name":"Global Business School for Health, University College London, London WC1E 6BT, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-8832-2670","authenticated-orcid":false,"given":"Maria","family":"Alevizopoulou","sequence":"additional","affiliation":[{"name":"School of Medicine, European University Cyprus, 2404 Nicosia, Cyprus"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Georgios A.","family":"Alevizopoulos","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Agioi Anargyroi General Oncological Hospital of Kifisia, National and Kapodistrian University of Athens, 14564 Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,5,3]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"270","DOI":"10.1056\/NEJMra1801490","article-title":"Psychotic Disorders","volume":"379","author":"Lieberman","year":"2018","journal-title":"N. 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