Evidence map›Paper›PMID 41969215›Full record

ReviewBJPsych open2026

Audio Visual Assisted Therapy Aid for Refractory Auditory Hallucinations (AVATAR) therapy for voice hearers: systematic review and meta-analysis.

Felix Opper, Sebastian Henges, Pawel Weinstein, Dana Arnheim, Laura Fässler, Olivier Percie du Sert, Izabela Stefaniak, Michel Sabé, Louise Birkedal Glenthøj, Neil Thomas and 3 more

Abstract readReview
PubMed Full text at PMC Publisher
In one paragraph

Review in BJPsych open, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Trial
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Felix OpperDepartment of Neuroscience and Psychiatry, https://ror.org/001w7jn25Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.ORCID https://orcid.org/0009-0003-6933-0710
Sebastian HengesDepartment of Neuroscience and Psychiatry, https://ror.org/001w7jn25Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.
Pawel WeinsteinDepartment of Neuroscience and Psychiatry, https://ror.org/001w7jn25Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.
Dana ArnheimDepartment of Neuroscience and Psychiatry, https://ror.org/001w7jn25Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.
Laura FässlerDepartment of Neuroscience and Psychiatry, https://ror.org/001w7jn25Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.
Olivier Percie du SertPrevention and Early Intervention Program for Psychoses, Douglas Research Centre, Montreal, Quebec, Canada.
Izabela StefaniakFaculty of Medicine, Lazarski University, Warsaw, Poland.
Michel SabéPsychiatry Department, Faculty of Medicine, University of Geneva, Geneva, Switzerland.
Louise Birkedal GlenthøjDepartment of Psychology, University of Copenhagen, Copenhagen, Denmark.
Neil ThomasCentre for Mental Health and Brain Sciences, Swinburne University of Technology, Melbourne, Australia.ORCID https://orcid.org/0000-0001-7006-6361
Chih-Sung LiangDepartment of Psychiatry, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.ORCID https://orcid.org/0000-0003-1138-5586
Brendon StubbsInstitute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, London, UK.
Kerem BögeDepartment of Neuroscience and Psychiatry, https://ror.org/001w7jn25Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.ORCID https://orcid.org/0000-0001-8263-4936

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAuditory verbal hallucinations (AVHs) are common and distressing symptoms across a range of psychiatric disorders, including schizophrenia spectrum disorders. Audio Visual Assisted Therapy Aid for Refractory Auditory Hallucinations (AVATAR) is an innovative therapeutic approach that facilitates dialogue with a digital avatar representing the voices that patients hear.

aimsThis systematic review and meta-analysis aimed to assess the efficacy, tolerability and acceptability of AVATAR therapy in reducing voice-related symptoms.

methodFollowing preregistration, we conducted a systematic review and meta-analysis of controlled trials of AVATAR therapy in samples primarily diagnosed with schizophrenia spectrum disorders. PubMed, CINAHL, Embase, PsycInfo, ClinicalTrials.gov, ISRCTN and Web of Science were searched in March 2025. We assessed bias and certainty with the Cochrane Risk-of-Bias 2 tool and the GRADE approach. Random-effects models were used to synthesise outcomes.

resultsEight AVATAR trials (

conclusionsFindings suggest that AVATAR therapy is effective at reducing AVH symptoms. Considering heterogeneous control groups and less clear evidence for secondary outcomes and longer follow-ups, further research is warranted.

Indexed as

AVATARdigital interventionschizophrenia spectrum disordersvirtual realityvoice hearing

Identifiers

PMID41969215
PMCPMC13107302

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.