ORIGINAL RESEARCH article
Front. Psychiatry
Sec. Schizophrenia
Volume 16 - 2025 | doi: 10.3389/fpsyt.2025.1608905
This article is part of the Research TopicMachine Learning Algorithms and Software Tools for Early Detection and Prognosis of SchizophreniaView all 5 articles
Assessment of cognitive function in patients with schizophrenia based on virtual reality serious games: A prospective nonrandomized clinical trial
Provisionally accepted
- 1School of Nursing, West China Hospital, Sichuan University, Chengdu, China
- 2West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
- 3West China School of Public Health, Sichuan University, Chengdu, Sichuan Province, China
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Conventional neuropsychological tests for assessing cognitive function in schizophrenia face critical limitations in ecological validity and efficiency. We developed Fruit Pioneer, a virtual reality serious game simulating real-world cognitive demands, to address these challenges. This study aimed to validate its diagnostic validity in differentiating cognitive impairments between schizophrenia patients (SZs) and healthy controls (HCs), while evaluating user experience feasibility.In this cross-sectional study, 107 participants (43 SZs, 64 HCs) underwent cognitive evaluation using the Brief Cognitive Assessment Tool for Schizophrenia (B-CATS) and Fruit Pioneer. Diagnostic validity was analyzed via receiver operating characteristic (ROC) curves and Spearman correlations. User experience was quantified using the Game Experience Questionnaire Core Module (GEQ-Core) and Simulator Sickness Questionnaire (SSQ).Results: SZs exhibited significantly poorer performance on B-CATS compared to HCs (all subtests p < 0.05). Among 16 Fruit Pioneer performance indicators, 13 demonstrated strong discriminative power (AUC > 0.7). The Total Game Score (TGS) achieved high accuracy (AUC = 0.911, sensitivity = 83.72%, specificity = 89.06%). Directionally consistent correlations were observed between game indicators and B-CATS scores (e.g., TGS vs. Digit Symbol Substitution Test: r = 0.66, p < 0.01).Participants reported high immersion (GEQ-Core immersion: 2.45 / 4) and minimal simulator sickness (SSQ total: 5.12 / 48).Fruit Pioneer provides a time-efficient (5-minute), ecologically valid tool for cognitive assessment in schizophrenia, demonstrating strong discriminative validity and user acceptability. Further validation should explore its clinical utility in broader populations and the association between its performance and functional outcomes.
Keywords: virtual reality, Serious game, Schizophrenia, cognitive assessment, Ecological Validity, Diagnostic validity
Received: 09 Apr 2025; Accepted: 18 Jul 2025.
Copyright: © 2025 吴, Zhuo, Yu, Li, Zhao and Xiandong. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Meng Xiandong, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
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