Taking modern psychiatry into the metaverse: Integrating augmented, virtual, and mixed reality technologies into psychiatric care

Abstract

The landscape of psychiatry is ever evolving and has recently begun to be influenced more heavily by new technologies. One novel technology which may have particular application to psychiatry is the metaverse, a three-dimensional digital social platform accessed via augmented, virtual, and mixed reality (AR/VR/MR). The metaverse allows the interaction of users in a virtual world which can be measured and manipulated, posing at once exciting new possibilities and significant potential challenges and risks. While the final form of the nascent metaverse is not yet clear, the immersive simulation and holographic mixed reality-based worlds made possible by the metaverse have the potential to redefine neuropsychiatric care for both patients and their providers. While a number of applications for this technology can be envisioned, this article will focus on leveraging the metaverse in three specific domains: medical education, brain stimulation, and biofeedback. Within medical education, the metaverse could allow for more precise feedback to students performing patient interviews as well as the ability to more easily disseminate highly specialized technical skills, such as those used in advanced neurostimulation paradigms. Examples of potential applications in brain stimulation and biofeedback range from using AR to improve precision targeting of non-invasive neuromodulation modalities to more innovative practices, such as using physiological and behavioral measures derived from interactions in VR environments to directly inform and personalize treatment parameters for patients. Along with promising future applications, we also discuss ethical implications and data security concerns that arise when considering the introduction of the metaverse and related AR/VR technologies to psychiatric research and care.

Keywords: biofeedback; brain stimulation; equity; ethics; medical education; metaverse web 3.0; psychiatry 3.0.

Figure 1

The top image (A) shows an example of doing rTMS targeting using only scalp based measurements and a cap based method. In this method, the center of the coil is placed over a target marked physically on a cap. The middle image (B) shows an example of doing rTMS targeting using a traditional neuronavigation method. In this method, the center of the coil is placed over a target digitally represented only on a computer monitor. The bottom image (C) shows an example of doing rTMS targeting using an AR neuronavigation method. In this method, the center of the coil is placed over a target that is digitally represented by a computer monitor and also virtually represented to appear as if it were on the patient's head (73, 74).