Schizophrenia is a mental disorder that appears in late adolescence or early adulthood and includes symptoms like delusions, flat affect, confusion, agitation, withdrawal, psychosis and bizarre behavior. Treatment includes cognitive behavioral therapy, antipsychotics, psychoeducation and cognitive rehabilitation using virtual reality apps. This document proposes a VR application set in a kitchen to improve rehabilitation for schizophrenia by working on social skills, executive functions, adherence to treatment and more through interaction, communication, concentration and memory exercises like cooking recipes. The goals are to improve various areas like social interaction, autonomy, spatial memory and progress could be tracked as tasks become more difficult.

1. Introduction of schizophrenia
• Schizophrenia is a mental disorder that
generally appears in late adolescence or
early adulthood.
• It is one of many brain diseases that may
include delusions, loss of personality (flat
affect), confusion, agitation, social
withdrawal, psychosis, and bizarre behavior.

2. DSM criteria for Schizophrenia
A.
Characteristic Schizophrenia symptoms: Two (or more) of the
following, each present for a significant portion of time during a 1
month period (or less if successfully treated):
1. Delusions
4. Hallucinations
3. Disorganized speech
4. Grossly disorganized or catatonic behavior
5."Negative" symptoms of Schizophrenia (Alogia, inappropriate social
skills, social isolation)

3. B. Social/occupational dysfunction: For a significant portion of the
time since the onset of the disturbance, one or more major areas of
functioning such as work, interpersonal relations, or self-care are
markedly below the level achieved prior to the onset.
C. Duration: Continuous signs of the disturbance persist for at
least 6 months. This 6-month period must include at least one
month of symptoms.

4. Treatment
Cognitive behaviour therapy
Antipsychotic
Psichoeducation
Cognitive rehabilitation ->VR app
Brain plasticity theory

5. Advantages and limitations of
the virtual reality
•
Created by Jaron Lanier
“Stimulations in real time through multiple sensorial channels”
 Visual
 Auditory
 Tactile
 Olfactory
 …

6. Advantages and limitations of
the virtual reality
• Advantages:
 Structuring therapy
 Acting feelings that generate freedom
 Role-playing
 Environment be modification
 Positive expectations
 Use of humor
 Control of the situation
• Limitations:
 The environment are difficulty access in vivo
 Aversive
 Higher degree of confidentiality

7. Antecedents of Virtual Reality in Schizophrenia
• Executive Functions
• Social Skills
• Adherence to Treatment
• Hallucinations and delusions
• Water Task

8. The VR application
o a kitchen, to try improving the rehabilitation
area of schizophrenia treatment.
o interaction, communication, concentration,
memory and perception are activated.
o Social skills and executive functions

9. The goals
• Interaction with other people
• Improve social skills
• Improve executive functions like attention, memory,
information process by cookingrecipes.
• Improve autonomy by learning cooking.
• Improve spatial memory and personal organitation in
the kitchen
• Will improved therapy adherence because the
motivation increase.
• Help him to be conscious about his learning process.

10. Application’s characteristics
• Six tables distributed by the class with a variety of kitchen
objects
• Four windows
• Ahead of the class there is a blackboard
• Class behind there is a closet with more kitchen tools, a
shelf with books containing recipes of cuisines, and a shelf
with the patient's own diaries
• The walls will be painted white, but the colour can be
changed according to the patient's mood
• The external environment may also vary; where patients
will see a forest, a city or a village.

16. Items that can vary according to patient characteristics
• Social skill is one of the difficulties of this patients
personal diary- functions:
- write down his cooking successes
- write his emotions,thoughts, moods
• The wall colour change
For more excitement, the walls will return red or orange
To sad emotions will return grey
To positive emotions will be light blue or light green
• External environment may also vary according to the patient's
progress

17. Interaction between the patient and virtual environment
1. Firstly
The patient stay alone (Adaptation).
2. Secondly
Appears the teacher (Goals).
3. Thirdly
Complain the goals and appear new
items.
4. Motivation
5. The goals will complicate
6. Treatment adherence

18. Conclusions
Advantages
– Support from other virtual reality programs for the treatment of schizophrenia
previous:
- VR-Based conversation Training Program for Patients with Schizophrenia: This is
a virtual reality is used to solve social skills.
- Pilot Studying of Assessing the Behaviours of Patients with Schizophrenia
towards a Virtual Avatar: the behaviour of the avatar and the patient was compared by
Positive and Negative Syndrome Scale.
- Water: In this application the patient have to work the spatial memory and
orientation

19. Symptom assessment: The symptom assessment is usually realized between the interviewer
and the patient. This evaluation is positive by two reasons:
1. standardized symptoms
2. The progress is more visual to patient
Progressive activity:
(Cocking in pairs)
Task
Difficulty
(Cocking alone,
only with the teacher)

20. • Treatment adherence: We think that Course of kitchen is a creative
activity in order to increase the motivation for doing the task and the
treatment adherence.
• Better than a real cocking class: The environment of virtual cooking
class is better than an ordinary cooking course because this allows
patients to have therapist support.
• Social Interaction: We have focused our application using as scenery an
interactive social situation, because this kind of situations is the
principal context where people’s schizophrenic behaviours are
manifested

21. Limitations (Aspects to improve)
To research: the use of virtual reality interactive immersive computer
environments allows one of the key variables in understanding psychosis.
The investigation in the future could consist in the elaboration of a
database where were reflected the individual variables of the patients and
his reactions in front of every stimulation and situation.
The differential types
Some of this possible variables:
The environment types
The genetic types

22. Global Assessment
Our intention with the virtual cooking class is working with these
symptoms, trying to promote: interaction, improving executive
functions such as attention, memory, user autonomy, improve selflearn to cook, better memory and spatial orientation, work
organization and the patient could be aware of their own learning
process.
The application that we have proposed we believe that accomplish
the goals we set for ourselves.