Depression, Mild or ModerateVR&depressionNCT07530952
Green VR for Depression
A study testing Studio-based VR experiences, Self-managed VR experiences and Standard Treatment in people with Depression, Mild or Moderate, run by Sykehuset Innlandet HF at 1 site in Norway.
Trial summary
Depression is a common mental health condition that can cause low mood, lack of energy, sleep problems, and difficulties in daily functioning. Many people with mild to moderate depression do not receive sufficient treatment because of barriers such as limited access to services, stigma, or low motivation to seek help. Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Depression, Mild or Moderate
- What is being tested?
- Studio-based VR experiences, Self-managed VR experiences and Standard Treatment
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 45 participants
- Where
- 1 siteNorway
- Study dates
- 1 Feb 2022to 1 Apr 2025
- Phase
- Interventional
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 years and older
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- able to speak and read in Norwegian
- diagnosed with mild to moderate depression
Who cannot join
- additional diagnosis for dementia or psychotic illness or other serious somatic illness
Trial locations and contacts
1 site in 1 country.
About this study
Official title: Virtual Nature Experiences as a Supplement in the Treatment of Moderate Depression
Depression is a common mental health condition that can cause low mood, lack of energy, sleep problems, and difficulties in daily functioning. Many people with mild to moderate depression do not receive sufficient treatment because of barriers such as limited access to services, stigma, or low motivation to seek help. Physical activity and contact with nature have been shown to improve mental health, and activities performed in natural environments ("green exercise") may provide additional psychological benefits compared with indoor exercise. However, people with depression may experience barriers to engaging in outdoor activities, such as low motivation, limited access to natural environments, or unfavorable weather conditions.
Virtual reality (VR) technology can simulate immersive natural environments and may provide a way to experience nature indoors. VR-mediated experiences of nature (or "virtual nature") can provide similar psychological benefits of rea-life nature experiences. Moreover, as virtual nature experiences have been found to elicit increased sense of nature connectedness and intention to perform green exercise, which may in turn support increase participation in actual green exercise. While virtual nature interventions have shown promising results in different health contexts and are considered safe and feasible, little research has examined their effects of integrating such medium within clinical standard treatments for depression.
Read more
The purpose of this study is to investigate whether virtual nature can be an effective supplement to standard treatment for patients with mild to moderate depression. Specifically, the study will evaluate whether the combination of standard treatment and virtual nature improves mood and reduces depressive symptoms compared with treatment as usual. The study will also explore whether the intervention influences participants' motivation to engage in physical activity and outdoor green exercise over time. Finally, the study will examine possible differences between two approaches to deliver virtual nature experiences to patients in treatment for depression, namely a "high-end" and laboratory-based approach vs a "low-end" and self-managed approach.
Participants will be recruited from a psychiatric outpatient clinic that treats individuals with depression and anxiety disorders. Eligible participants will be adults diagnosed with mild to moderate depression. Patients with additional diagnosis for dementia or psychotic illness or other serious somatic illness will be excluded. Participants will be randomly assigned to one of three groups: (1) a "high-end" and laboratory-based VR intervention combined with standard treatment, (2) a "low-end" and self-managed VR intervention combined with standard treatment, or (3) a control group receiving only standard treatment. The intervention will last three weeks, and participants will be assessed at baseline, immediately after the first session, after the intervention period, and at follow-up.
The study will examine several outcomes, both to test acute and longitudinal effects. Specifically, to test for acute effects of the two VR approaches, tested outcomes include affect state, feelings of nature connectedness, intention to perform green exercise and experiences with the virtual environment (such as enjoyment, immersion, and possible side effects like cyber sickness). To test the longitudinal effects, tested outcomes include mood, symptoms of depression and anxiety, and changes in physical activity and nature connectedness.
The main hypothesis is that patients who receive virtual nature in addition to their usual treatment will experience greater improvements in mood and depressive symptoms compared with patients receiving standard treatment alone. A secondary hypothesis is that exposure to virtual nature may increase participants' motivation and engagement in real-world outdoor physical activity over time. Finally, it is expected that the high-end and lab-based VR intervention will provide more positive overall effects.
This research will provide new knowledge about whether virtual nature experiences can support mental health treatment and help people with depression become more physically active and connected to nature. If effective, the intervention could offer a low-cost and accessible supplement to existing treatment approaches for depression.
- Conditions
- Depression, Mild or Moderate
- Being tested
- Studio-based VR experiences, Self-managed VR experiences, Standard Treatment
- Medical subject headings
- Depression, Lymphoma, Follicular
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Studio-based VR experiencesOther
High-end VR experience delivered by the researcher in a studio, delivered weekly, consisting of a simulated nature walk delivered through a high-end VR system connected to a manually-driven treadmill.
Self-managed VR experiencesOther
Low-end VR experience self-managed by the participants. After an introductory meeting with the researcher, the participants receive, for the duration of the intervention, a standalone VR headset containing a pre-set library of virtual nature experiences. The participants are encouraged to use the headset daily. The time spent using the VR headset is recorded through the device.
Standard TreatmentOther
Standard treatment with therapist
| Study group | Role | What they receive |
|---|---|---|
| Control (TAU) | Active comparator | Standard treatment with therapist Receives: Other: Standard Treatment |
| Studio-based | Experimental | Not described Receives: Other: Studio-based VR experiences; Other: Standard Treatment |
| Self-managed | Experimental | Not described Receives: Other: Self-managed VR experiences; Other: Standard Treatment |
What is being measured
The primary outcome is the main question the study is designed to answer.
Beck depression inventory II (BDI-II)
The BDI-II is a 21-item self-report questionnaire designed to measure the severity of depression.
The total score is calculated by summing the ratings (0-3) for all 21 items, with minimum score 0 (no or minimal depressive symptoms) and maximum score 63 (severe, high-level depressive symptoms).
A Norwegian translation of the scale commonly used in clinical settings is used in the study.
Measured: Baseline; post-intervention (week 3); follow-up (week 12).
Beck anxiety inventory (BAI)
The BAI is a 21-item self-report questionnaire used to measure the severity of anxiety in adults and adolescents.
Each item is rated from 0 ("not at all") to 3 ("a lot"). The total score is calculated by summing the ratings for all 21 items (minimum value 0 and maximum value 63), with higher scores indicating greater severity of anxiety.
A Norwegian translation of the scale commonly used in clinical settings is used in the study.
Measured: Baseline; post-intervention (week 3); follow-up (week 12).
Secondary outcomes (5)
Hopkins symptom checklist (HSCL-10)
The HSCL-10 is a 10-item self-report questionnaire designed to screen for symptoms of anxiety and depression, commonly used in both clinical and epidemiological studies to measure psychological distress. It includes 4 items related to anxiety and 6 items related to depression, focusing on symptoms experienced during the past week.
Each item is rated on a four-point scale (1 = "Not at all"; 2 = "A little"; 3 = "Quite a lot"; 4 = "Extremely"). The score is calculated by taking the mean of all item scores. The minimum Value is 1.0 (no psychological distress) while the maximum Value 4.0 (extreme psychological distress). A Cut-off Point is set at a mean score of 1.85 to identify individuals experiencing significant mental health distress.
A Norwegian translation of the scale commonly used in clinical settings is used in the study.
Measured: Baseline; post-intervention (week 3); follow-up (week 12).
Leisure time exercise questionnaire (LTEQ)
The LTEQ is a self-administered tool designed to assess the frequency and intensity of a person's leisure-time physical activity in a regular week (7 days). It measures how many times per week a person engages in strenuous, moderate, and mild/light physical activity for at least 15 minutes.
In this study, a modified version was also used to measure "active commuting", defined in a caption as "Walkin, running, biking to and from destinations such as work, the grocery, etc." The participant is required to report the number of times they engage in each level of intensity (strenuous, moderate, and mild/light) during a regular week. Examples are provided for each level of intensity. Higher scores indicate higher levels of activity.
The total score is calculated through the following formula: (n strenuous x 9) + (n moderate x 5) + (n mild/light x 3).
A Norwegian translation is used.
Measured: Baseline; post-intervention (week 3); follow-up (week 12).
Intention to perform green exercise (INT-GE)
The INT-GE is a questionnaire component designed to measure an individual's motivation, plans, and likelihood of engaging in physical activity within natural environments (e.g., parks, forests, coasts). It is often developed based on the Theory of Planned Behaviour (TPB) to predict future green exercise behaviour.
The scale contains five items, each rated on a 1-7 Likert scale, with the total score calculated as the mean of all items. The minimum score is 1.0 (no intention to perform green exercise), while the maximum is 5.0 (strong intention to perform green exercise).
A Norwegian translation of the scale is used.
Measured: Baseline; immediately after the 1st VR exposure; post-intervention (week 3); follow-up (week 12).
Connectedness with nature scale (CNS)
The state version of the CNS measures an individual's affective, experiential connection to the natural world at a given moment ("right now"). Based on the previous trait version of the scale, the state version is sensitive to acute changes. It contains 13 items, which are rated on a 1-7 Likert scale (1 = "Strongly disagree"; 7 = "Strongly agree"). The total score is calculated as the mean of all items, with lower scores (minimum value = 1.0) indicating a weaker sense of connectedness, while the higher scores (maximum value = 7.0) indicate a stronger sense of connectedness.
A Norwegian translation of the scale is used.
Measured: Baseline; immediately after the 1st VR exposure; post-intervention (week 3); follow-up (week 12).
Affect Scale (PAAS)
The PAAS is a 12-item self-report questionnaire designed to measure feeling states. It evaluates emotional responses across four distinct subscales (Positive affect, Negative affect, Tranquillity, and Fatigue) and is especially sensitive to acute changes associated with physical activity.
The PAAS consists of 12 items (three items per subscale), each describing a feeling (e.g., "Energetic", "Discouraged", "Relaxed", "Worn-out"). Participants rate their current feelings on a 5-point Likert scale, commonly ranging from 0 ("do not feel") to 4 ("feel very strongly"). Mean scores are calculated for each subscale, with a minimum possible score of 0 and a maximum of 4, with higher scores indicating higher levels for the subcategory.
A Norwegian translation is used.
Measured: Baseline; immediately after the 1st VR exposure; post-intervention (week 3); follow-up (week 12).
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted15 Apr 2026
- Study start1 Feb 2022
- Primary completion1 Apr 2025
- Study completion1 Apr 2025
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Depression, Mild or ModerateStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Supportive care
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Double blind
- Who is masked
- Participant, Care provider
- Enrolment
- 45 participants (actual)
Sponsor and investigators
- Lead sponsor
- Sykehuset Innlandet HF
- Sponsor type
- University, hospital or other
- Collaborators
- University of South-Eastern Norway
- Responsible party
- Sponsor
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07530952
- Sponsor's protocol ID
- 258745
- Acronym
- VR&depression
- Status last verified
- Mar 2026
- First submitted
- 26 Mar 2026
- Last updated
- 5 May 2026
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No
Study at a glance
From the registry record, last updated by the sponsor on 5 May 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Virtual Nature Experiences as a Supplement in the Treatment of Moderate Depression
- ClinicalTrials.gov ID
- NCT07530952
- Acronym / sponsor ID
- VR&depression / 258745
- Conditions
- Depression, Mild or Moderate
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 45 participants (actual)
- Lead sponsor
- Sykehuset Innlandet HFUniversity, hospital or other
- Collaborators
- University of South-Eastern Norway
- Study start
- 1 Feb 2022 (actual)
- Primary completion
- 1 Apr 2025 (actual)
- Study completion
- 1 Apr 2025 (actual)
- First posted
- 15 Apr 2026 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
Depression is a common mental health condition that can cause low mood, lack of energy, sleep problems, and difficulties in daily functioning. Many people with mild to moderate depression do not receive sufficient treatment because of barriers such as limited access to services, stigma, or low motivation to seek help. Physical activity and contact with nature have been shown to improve mental health, and activities performed in natural environments ("green exercise") may provide additional psychological benefits compared with indoor exercise. However, people with depression may experience barriers to engaging in outdoor activities, such as low motivation, limited access to natural environments, or unfavorable weather conditions.
Virtual reality (VR) technology can simulate immersive natural environments and may provide a way to experience nature indoors. VR-mediated experiences of nature (or "virtual nature") can provide similar psychological benefits of rea-life nature experiences. Moreover, as virtual nature experiences have been found to elicit increased sense of nature connectedness and intention to perform green exercise, which may in turn support increase participation in actual green exercise. While virtual nature interventions have shown promising results in different health contexts and are considered safe and feasible, little research has examined their effects of integrating such medium within clinical standard treatments for depression.
The purpose of this study is to investigate whether virtual nature can be an effective supplement to standard treatment for patients with mild to moderate depression. Specifically, the study will evaluate whether the combination of standard treatment and virtual nature improves mood and reduces depressive symptoms compared with treatment as usual. The study will also explore whether the intervention influences participants' motivation to engage in physical activity and outdoor green exercise over time. Finally, the study will examine possible differences between two approaches to deliver virtual nature experiences to patients in treatment for depression, namely a "high-end" and laboratory-based approach vs a "low-end" and self-managed approach.
Participants will be recruited from a psychiatric outpatient clinic that treats individuals with depression and anxiety disorders. Eligible participants will be adults diagnosed with mild to moderate depression. Patients with additional diagnosis for dementia or psychotic illness or other serious somatic illness will be excluded. Participants will be randomly assigned to one of three groups: (1) a "high-end" and laboratory-based VR intervention combined with standard treatment, (2) a "low-end" and self-managed VR intervention combined with standard treatment, or (3) a control group receiving only standard treatment. The intervention will last three weeks, and participants will be assessed at baseline, immediately after the first session, after the intervention period, and at follow-up.
The study will examine several outcomes, both to test acute and longitudinal effects. Specifically, to test for acute effects of the two VR approaches, tested outcomes include affect state, feelings of nature connectedness, intention to perform green exercise and experiences with the virtual environment (such as enjoyment, immersion, and possible side effects like cyber sickness). To test the longitudinal effects, tested outcomes include mood, symptoms of depression and anxiety, and changes in physical activity and nature connectedness.
The main hypothesis is that patients who receive virtual nature in addition to their usual treatment will experience greater improvements in mood and depressive symptoms compared with patients receiving standard treatment alone. A secondary hypothesis is that exposure to virtual nature may increase participants' motivation and engagement in real-world outdoor physical activity over time. Finally, it is expected that the high-end and lab-based VR intervention will provide more positive overall effects.
This research will provide new knowledge about whether virtual nature experiences can support mental health treatment and help people with depression become more physically active and connected to nature. If effective, the intervention could offer a low-cost and accessible supplement to existing treatment approaches for depression.
Study design
- Primary purpose
- Supportive care
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Double blind (participant, care provider)
- Number of arms
- 3
| Arm | Type | Receives |
|---|---|---|
| Control (TAU) | Active comparator | Other: Standard TreatmentStandard treatment with therapist |
| Studio-based | Experimental | Other: Studio-based VR experiences, Other: Standard Treatment |
| Self-managed | Experimental | Other: Self-managed VR experiences, Other: Standard Treatment |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (2 listed)
- able to speak and read in Norwegian
- diagnosed with mild to moderate depression
Key exclusion criteria (1 listed)
- additional diagnosis for dementia or psychotic illness or other serious somatic illness
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Studio-based VR experiencesHigh-end VR experience delivered by the researcher in a studio, delivered weekly, consisting of a simulated nature walk delivered through a high-end VR system connected to a manually-driven treadmill. | Other | Studio-based |
| Self-managed VR experiencesLow-end VR experience self-managed by the participants. After an introductory meeting with the researcher, the participants receive, for the duration of the intervention, a standalone VR headset containing a pre-set library of virtual nature experiences. The participants are encouraged to use the headset daily. The time spent using the VR headset is recorded through the device. | Other | Self-managed |
| Standard TreatmentStandard treatment with therapist | Other | Control (TAU), Self-managed, Studio-based |
Primary outcome
Beck depression inventory II (BDI-II)
Time frame: Baseline; post-intervention (week 3); follow-up (week 12).
The BDI-II is a 21-item self-report questionnaire designed to measure the severity of depression. The total score is calculated by summing the ratings (0-3) for all 21 items, with minimum score 0 (no or minimal depressive symptoms) and maximum score 63 (severe, high-level depressive symptoms). A Norwegian translation of the scale commonly used in clinical settings is used in the study.
Beck anxiety inventory (BAI)
Time frame: Baseline; post-intervention (week 3); follow-up (week 12).
The BAI is a 21-item self-report questionnaire used to measure the severity of anxiety in adults and adolescents. Each item is rated from 0 ("not at all") to 3 ("a lot"). The total score is calculated by summing the ratings for all 21 items (minimum value 0 and maximum value 63), with higher scores indicating greater severity of anxiety. A Norwegian translation of the scale commonly used in clinical settings is used in the study.
5 secondary outcomes
Hopkins symptom checklist (HSCL-10)
Time frame: Baseline; post-intervention (week 3); follow-up (week 12).
Leisure time exercise questionnaire (LTEQ)
Time frame: Baseline; post-intervention (week 3); follow-up (week 12).
Intention to perform green exercise (INT-GE)
Time frame: Baseline; immediately after the 1st VR exposure; post-intervention (week 3); follow-up (week 12).
Connectedness with nature scale (CNS)
Time frame: Baseline; immediately after the 1st VR exposure; post-intervention (week 3); follow-up (week 12).
Affect Scale (PAAS)
Time frame: Baseline; immediately after the 1st VR exposure; post-intervention (week 3); follow-up (week 12).
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 5 May 2026.
- Calogiuri, G., Litleskare, S., Fagerheim, K. A., Rydgren, T. L., Brambilla, E., \& Thurston, M. (2018). Experiencing nature through immersive virtual environments: Environmental perceptions, physical engagement, and affective responses during a simulatedLink provided by the sponsor.
- Godin, G., \& Shephard, R. (1985). A simple method to assess exercise behavior in the community. Canadian journal of applied sport sciences. Journal canadien des sciences appliquees au sport, 10(3), 141-146.Link provided by the sponsor.
- Hartig, T. (1996). Validation of a measure of perceived environmental restorativeness. Goteborg psychological reports, 26(7).Link provided by the sponsor.
- Mayer, F. S., \& Frantz, C. M. (2004). The connectedness to nature scale: A measure of individuals' feeling in community with nature. Journal of environmental psychology, 24(4), 503-515.Link provided by the sponsor.
- Nichols, S., Haldane, C., \& Wilson, J. R. (2000). Measurement of presence and its consequences in virtual environments. International Journal of Human-Computer Studies, 52(3), 471-491.Link provided by the sponsor.
- Individual participant dataSharing planned: No
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
The record lists no contact. Use the official record to reach the sponsor.
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Studio-based VR experiences, Self-managed VR experiences and Standard Treatment in people with Depression, Mild or Moderate, run by Sykehuset Innlandet HF at 1 site in Norway.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 2 inclusion and 1 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 5 May 2026. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in Norway. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Beck depression inventory II (BDI-II) (time frame: Baseline; post-intervention (week 3); follow-up (week 12).). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 5 May 2026.