{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T05:34:35Z","timestamp":1787895275072,"version":"build-2784847793"},"reference-count":48,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2025,2,18]],"date-time":"2025-02-18T00:00:00Z","timestamp":1739836800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Assistance Publique H\u00f4pitaux de Marseille (AP-HM)","award":["RCB A00878-41"],"award-info":[{"award-number":["RCB A00878-41"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Objectives: Modern therapeutic strategies incorporating virtual reality (VR) have emerged as potential treatments for generalized anxiety disorder (GAD), a prevalent and debilitating condition that is challenging to cure. This study aimed to evaluate the efficacy of VR combined with relaxation techniques in patients with GAD by comparing VR-based relaxation with standard mental imagery (MI) relaxation. Methods: Fifty-eight patients with GAD participated in a randomized comparative trial. Specific virtual environments were created using an inexpensive game engine\/level editor (GLE). Psychometric scales and physiological instruments were employed to assess the effects of relaxation therapy on anxiety, depression, quality of life, presence within virtual environments and cybersickness. Results: Both the VR and MI groups demonstrated statistically significant improvements in anxiety, worry and mental quality of life scores. However, no significant differences were observed between the two groups in pre\u2013post comparisons of psychometric scores. The VR group exhibited a noticeably higher protocol completion rate and a significant increase in heart rate variability during the therapy. The level of presence in the VR group was satisfactory and significantly correlated with physiological improvements and anxiety reduction, while cybersickness remained low. Participants\u2019 preferences for specific virtual environments for relaxation are also discussed. Conclusions: These findings suggest that teaching and practicing relaxation in VR holds therapeutic potential for the treatment of GAD. Further research leveraging advanced VR sensory equipment and artificial intelligence agents is warranted to enhance therapeutic outcomes and explore additional applications.<\/jats:p>","DOI":"10.3390\/jcm14041351","type":"journal-article","created":{"date-parts":[[2025,2,18]],"date-time":"2025-02-18T06:41:12Z","timestamp":1739860872000},"page":"1351","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Virtual Reality and Relaxation for the Treatment of Generalized Anxiety Disorder: A Randomized Comparative Study with Standard Intervention"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1511-0133","authenticated-orcid":false,"given":"Eric","family":"Malbos","sequence":"first","affiliation":[{"name":"Department of Adult Psychiatry, Sainte Marguerite University Hospital, Assistance Publique H\u00f4pitaux de Marseille APHM, 13009 Marseille, France"},{"name":"Equipe Imothep, Institut Fresnel, UMR 7249, Ecole Centrale Marseille, Aix-Marseille University, 13005 Marseille, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nad\u00e8ge","family":"Chichery","sequence":"additional","affiliation":[{"name":"Department of Adult Psychiatry, Sainte Marguerite University Hospital, Assistance Publique H\u00f4pitaux de Marseille APHM, 13009 Marseille, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Baptiste","family":"Borwell","sequence":"additional","affiliation":[{"name":"Department of Adult Psychiatry, Sainte Marguerite University Hospital, Assistance Publique H\u00f4pitaux de Marseille APHM, 13009 Marseille, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriel","family":"Weindel","sequence":"additional","affiliation":[{"name":"Laboratory of Cognitive Neuroscience, UMR 7291, Aix-Marseille University, 13331 Marseille, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7964-7648","authenticated-orcid":false,"given":"Jordan","family":"Molitor","sequence":"additional","affiliation":[{"name":"Department of Adult Psychiatry, Sainte Marguerite University Hospital, Assistance Publique H\u00f4pitaux de Marseille APHM, 13009 Marseille, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6391-6428","authenticated-orcid":false,"given":"M\u00e9lodie","family":"Einig-Iscain","sequence":"additional","affiliation":[{"name":"Department of Adult Psychiatry, Sainte Marguerite University Hospital, Assistance Publique H\u00f4pitaux de Marseille APHM, 13009 Marseille, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julien","family":"Seimandi","sequence":"additional","affiliation":[{"name":"Department of Adult Psychiatry, Sainte Marguerite University Hospital, Assistance Publique H\u00f4pitaux de Marseille APHM, 13009 Marseille, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christophe","family":"Lan\u00e7on","sequence":"additional","affiliation":[{"name":"Department of Adult Psychiatry, Sainte Marguerite University Hospital, Assistance Publique H\u00f4pitaux de Marseille APHM, 13009 Marseille, France"},{"name":"Centre de Recherche en Sant\u00e9 Mentale et Psychiatrie, 13090 Montperrin, France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,2,18]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"American Psychiatric Association (2013). 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