Innovative Journal Journal of Medical Research and Health Sciences 2589-9031 4 3 2021 3 17 Olfactory Virtual Reality (OVR) for Wellbeing and Reduction of Stress, Anxiety and Pain 1 David Tomasi Hannah Ferris, MS University of Vermont Larner College of Medicine, Department of Pharmacology; University of Vermont Priscilla Booraem, MS, GT University of Vermont Medical Center, Inpatient Psychiatry Lindsay Enman, MSW, GT University of Vermont Medical Center, Inpatient Psychiatry Sheri Gates, MA, GT University of Vermont Medical Center, Inpatient Psychiatry Emily Reyns, MA, R-DMT, MHC, GT University of Vermont Integrative Health, College of Nursing and Health Sciences; University of Vermont Medical Center, Inpatient Psychiatry; Journal Article https://doi.org/10.15520/jmrhs.v4i3.322 Abstract Background: As part of a consistent effort to examine and provide integrative medical approaches to the therapeutic offering for psychophysical health, this study investigates the utilization of Olfactory Virtual Reality (OVR) in an inpatient psychiatry unit, more specifically in the Shepardson 3 Inpatient Psychiatry Unit at the University of Vermont Medical Center, in Burlington, VT, USA. Objectives: The purpose of this protocol is to explore the therapeutic value of olfactory virtual reality (OVR) in the above described population, and to collect statistically significant data to determine the feasibility of potential future OVR studies. Method: Direct subject observation and monitoring in the context of Olfactory Virtual Reality (OVR) sessions and Qualitative data collection via the administration of subject surveys, subdivided in: a) Pre-OVR experience, b) Immediate post-OVR experience, and c) 1-to-3-hour post-OVR experience questionnaires. Results: The research yielded positive outcomes in all areas investigated, despite challenges related to the utilization of the device itself, issues in individual olfactory threshold, and COVID-19 restrictions and limitations. Conclusion: The outcome of this study indicates that the utilization of olfactory virtual reality technologies is a safe and effective integrative approach to target several aspects of psychological and physical health such as anxiety, stress, and pain, in combination with the psychotherapeutic and pharmacological standards of care in inpatient psychiatry. Amores, J, Richer, R, Zhao, N, Maes, P, Eskofier, B, Promoting relaxation using virtual reality, olfactory interfaces and wearable EEG, 2018 IEEE 15th International Conference on Wearable and Implantable Body Sensor Networks (BSN), 2018, Las Vegas, NV, 98, 101 Micaroni, Lorenzo, Carulli, Marina, Ferrise, Francesco, Gallace, Alberto, Bordegoni, Monica, An Olfactory Display to Study the Integration of Vision and Olfaction in a Virtual Reality Environment, Journal of Computing and Information Science in Engineering, 2019, 19, 3, 31015, 31015, 1530-9827, 1944-7078, 10.1115/1.4043068, ASME International, https://dx.doi.org/10.1115/1.4043068 OVR Technology presentation, research and description, https://ovrtechnology.com/ Cieślik, Błażej, Mazurek, Justyna, Rutkowski, Sebastian, Kiper, Paweł, Turolla, Andrea, Szczepańska-Gieracha, Joanna, Virtual reality in psychiatric disorders: A systematic review of reviews, Complementary Therapies in Medicine, 2020, 52, 102480, 102480, 0965-2299, 10.1016/j.ctim.2020.102480, Elsevier BV, https://dx.doi.org/10.1016/j.ctim.2020.102480 Pourmand, Ali, Davis, Steven, Marchak, Alex, Whiteside, Tess, Sikka, Neal, Virtual Reality as a Clinical Tool for Pain Management, Current Pain and Headache Reports, 2018, 22, 8, 53, 53, 1531-3433, 1534-3081, 10.1007/s11916-018-0708-2, Springer Science and Business Media LLC, https://dx.doi.org/10.1007/s11916-018-0708-2 Abhinav, RP, Sweta, VR, Ramesh, Asha, Role of virtual reality in pain perception of patients following the administration of local anesthesia, Annals of Maxillofacial Surgery, 2019, 9, 1, 110, 110, 2231-0746, 10.4103/ams.ams_263_18, Medknow, https://dx.doi.org/10.4103/ams.ams_263_18 Fodor, Liviu A., Coteț, Carmen D., Cuijpers, Pim, Szamoskozi, Ștefan, David, Daniel, Cristea, Ioana A., The effectiveness of virtual reality based interventions for symptoms of anxiety and depression: A meta-analysis, Scientific Reports, 2018, 8, 1, 10323, 10323, 2045-2322, 10.1038/s41598-018-28113-6, Springer Science and Business Media LLC, https://dx.doi.org/10.1038/s41598-018-28113-6 Rizzo, Albert ‘Skip’, Shilling, Russell, Clinical Virtual Reality tools to advance the prevention, assessment, and treatment of PTSD, European Journal of Psychotraumatology, 2017, 8, sup5, 1414560, 1414560, 2000-8198, 2000-8066, 10.1080/20008198.2017.1414560, Informa UK Limited, https://dx.doi.org/10.1080/20008198.2017.1414560 Hassan, C, Antonelli, G, 2020) ‘I want to have virtual reality distraction during my colonoscopy!, Endoscopy International Open, 08, 10, 1389, 1391 Wittkopf, Priscilla G., Lloyd, Donna M., Coe, Olivia, Yacoobali, Shafiyyah, Billington, Jac, The effect of interactive virtual reality on pain perception: a systematic review of clinical studies, Disability and Rehabilitation, 2020, 42, 26, 3722, 3733, 0963-8288, 1464-5165, 10.1080/09638288.2019.1610803, Informa UK Limited, https://dx.doi.org/10.1080/09638288.2019.1610803 Gebara, Cristiane M., Barros-Neto, Tito P. de, Gertsenchtein, Leticia, Lotufo-Neto, Francisco, Virtual reality exposure using three-dimensional images for the treatment of social phobia, Revista Brasileira de Psiquiatria, 2015, 38, 1, 24, 29, 1516-4446, 1809-452X, 10.1590/1516-4446-2014-1560, FapUNIFESP (SciELO), https://dx.doi.org/10.1590/1516-4446-2014-1560 Sabelman, Eric E., Lam, Roger, The real-life dangers of augmented reality, IEEE Spectrum, 2015, 52, 7, 48, 53, 0018-9235, 10.1109/mspec.2015.7131695, Institute of Electrical and Electronics Engineers (IEEE), https://dx.doi.org/10.1109/mspec.2015.7131695 Kenwright, Ben, Virtual Reality: Ethical Challenges and Dangers [Opinion],, IEEE Technology and Society Magazine, 2018, 37, 4, 20, 25, 0278-0097, 1937-416X, 10.1109/mts.2018.2876104, Institute of Electrical and Electronics Engineers (IEEE), https://dx.doi.org/10.1109/mts.2018.2876104 Sharma, A, Bajpai, P, Singh, S, Khatter, K, , Virtual Reality: Blessings and Risk Assessment, Human-Computer Interaction (cs.HC), Ithaca, NY, 2017 Urueña López, Alberto, Mateo, Fernando, Navío-Marco, Julio, Martínez-Martínez, José María, Gómez-Sanchís, Juan, Vila-Francés, Joan, José Serrano-López, Antonio, Analysis of computer user behavior, security incidents and fraud using Self-Organizing Maps, Computers & Security, 2019, 83, 38, 51, 0167-4048, 10.1016/j.cose.2019.01.009, Elsevier BV, https://dx.doi.org/10.1016/j.cose.2019.01.009 Hicks, Tyler M, Digital Detox - Addressing the Issue of Screen Addiction in Millennials" (2019). Undergraduate Honors Theses. Paper 513. https://dc.etsu.edu/honors/513, Digital Detox - Addressing the Issue of Screen Addiction in Millennials, 2019, https://dc.etsu.edu/honors/513 Croy, Ilona, Hummel, Thomas, Olfaction as a marker for depression, Journal of Neurology, 2017, 264, 4, 631, 638, 0340-5354, 1432-1459, 10.1007/s00415-016-8227-8, Springer Science and Business Media LLC, https://dx.doi.org/10.1007/s00415-016-8227-8 Abramowitz, Eitan G., Lichtenberg, Pesach, Hypnotherapeutic Olfactory Conditioning (HOC):Case Studies of Needle Phobia, Panic Disorder, and Combat-Induced PTSD, International Journal of Clinical and Experimental Hypnosis, 2009, 57, 2, 184, 197, 0020-7144, 1744-5183, 10.1080/00207140802665450, Informa UK Limited, https://dx.doi.org/10.1080/00207140802665450 Amores, J, Maes, P, Essence: Olfactory interfaces for unconscious influence of mood and cognitive performance, ACM SIGCHI, 2017, 28, 34 Tomasi, D, Critical Neuroscience and Philosophy. A Scientific Re-examination of the Mind-body Problem, Palgrave Macmillan, Basingstoke, UK, 2020 Munyan, Benson G., Neer, Sandra M., Beidel, Deborah C., Jentsch, Florian, Olfactory Stimuli Increase Presence in Virtual Environments, PLOS ONE, 2016, 11, 6, e0157568, e0157568, 1932-6203, 10.1371/journal.pone.0157568, Public Library of Science (PLoS), https://dx.doi.org/10.1371/journal.pone.0157568 Rochet, Marion, El-Hage, Wissam, Richa, Sami, Kazour, François, Atanasova, Boriana, Depression, Olfaction, and Quality of Life: A Mutual Relationship, Brain Sciences, 2018, 8, 5, 80, 80, 2076-3425, 10.3390/brainsci8050080, MDPI AG, https://dx.doi.org/10.3390/brainsci8050080 Mitchell, A S, The mediodorsal thalamus as a higher order thalamic relay nucleus important for learning and decision-making, Neurosci. Biobehav. Rev, 2015, 54, 76, 88 Courtiol, Emmanuelle, Wilson, Donald A., The olfactory thalamus: unanswered questions about the role of the mediodorsal thalamic nucleus in olfaction, Frontiers in Neural Circuits, 2015, 9, 1662-5110, 10.3389/fncir.2015.00049, Frontiers Media SA, https://dx.doi.org/10.3389/fncir.2015.00049 Jacobson, Green, Haase, Szajer, Murphy, Differential Effects of BMI on Brain Response to Odor in Olfactory, Reward and Memory Regions: Evidence from fMRI, Nutrients, 2019, 11, 4, 926, 926, 2072-6643, 10.3390/nu11040926, MDPI AG, https://dx.doi.org/10.3390/nu11040926 The Inpatient Psychiatry Unit at UVM Medical Center, https://www.uvmhealth.org/medcenter/departments-and-programs/inpatient-psychiatry UVMMC) Shepardson 3, department of inpatient psychiatry, https://www.uvmhealth.org/medcenter/location/inpatient-psychiatry-shepardson-3 Meng, S L, Tak, E W, Li, W, , C & L, The Longitudinal Associations between Physical Health and Mental Health among Older Adults, Aging & Mental Health, 1990, 24, 12, 12 Carrigan, N, Dysch, , Salkovskis, , A Replication and Treatment Case Series', Behavioural and Cognitive Psychotherapy, The Impact of Health Anxiety in Multiple Sclerosis: A Replication, 2018, 46, 2, 148, 167, https://doi.org/10.1017/S135246581700056X Lupien, Sonia J., McEwen, Bruce S., Gunnar, Megan R., Heim, Christine, Effects of stress throughout the lifespan on the brain, behaviour and cognition, Nature Reviews Neuroscience, 2009, 10, 6, 434, 445, 1471-003X, 1471-0048, 10.1038/nrn2639, Springer Science and Business Media LLC, https://dx.doi.org/10.1038/nrn2639 Stanton, Robert, To, Quyen G., Khalesi, Saman, Williams, Susan L., Alley, Stephanie J., Thwaite, Tanya L., Fenning, Andrew S., Vandelanotte, Corneel, Depression, Anxiety and Stress during COVID-19: Associations with Changes in Physical Activity, Sleep, Tobacco and Alcohol Use in Australian Adults, International Journal of Environmental Research and Public Health, 2020, 17, 11, 4065, 4065, 1660-4601, 10.3390/ijerph17114065, MDPI AG, https://dx.doi.org/10.3390/ijerph17114065 Kamath, Vidyulata, Paksarian, Diana, Cui, Lihong, Moberg, Paul J, Turetsky, Bruce I, Merikangas, Kathleen R, Olfactory processing in bipolar disorder, major depression, and anxiety, Bipolar Disorders, 2018, 20, 6, 547, 555, 1398-5647, 10.1111/bdi.12625, Wiley, https://dx.doi.org/10.1111/bdi.12625 Kohli, Preeti, Soler, Zachary M., Nguyen, Shaun A., Muus, John S., Schlosser, Rodney J., The Association Between Olfaction and Depression: A Systematic Review, Chemical Senses, 2016, 41, 6, 479, 486, 0379-864X, 1464-3553, 10.1093/chemse/bjw061, Oxford University Press (OUP), https://dx.doi.org/10.1093/chemse/bjw061 Croy, Ilona, Hummel, Thomas, Olfaction as a marker for depression, Journal of Neurology, 2017, 264, 4, 631, 638, 0340-5354, 1432-1459, 10.1007/s00415-016-8227-8, Springer Science and Business Media LLC, https://dx.doi.org/10.1007/s00415-016-8227-8 Eisenberg, D M, Kaptchuk, T J, Post, D E, Hrbek, A L, O'connor, B B, Osypiuk, K, Wayne, P M, Buring, J E, Levy, D B, Establishing an Integrative Medicine Program Within an Academic Health Center: Essential Considerations. Academic medicine : journal of the Association of, American Medical Colleges, 2016, 91, 9, 1223, 1230 Gartlehner, G, Gaynes, B N, Amick, H R, Asher, G N, Morgan, L C, Coker-Schwimmer, E, Comparative benefits and harms of antidepressant, psychological, complementary, and exercise treatments for major depression: an evidence report for a clinical practice guideline from the American College of Physicians, Ann Intern Med, 2016 Tomasi, D, Mind-Body Medicine in Inpatient Psychiatry. New York, NY: Ibidem Verlag / Columbia University Press, 2019, Ibidem Verlag / Columbia University Press, New York, NY Bastos, Andre Goettems, Pinto Guimarães, Luciano Santos, Trentini, Clarissa Marceli, Neurocognitive changes in depressed patients in psychodynamic psychotherapy, therapy with fluoxetine and combination therapy, Journal of Affective Disorders, 2013, 151, 3, 1066, 1075, 0165-0327, 10.1016/j.jad.2013.08.036, Elsevier BV, https://dx.doi.org/10.1016/j.jad.2013.08.036 Hohmann, Louisa, Bradt, Joke, Stegemann, Thomas, Koelsch, Stefan, Effects of music therapy and music-based interventions in the treatment of substance use disorders: A systematic review, PLOS ONE, 2017, 12, 11, e0187363, e0187363, 1932-6203, 10.1371/journal.pone.0187363, Public Library of Science (PLoS), https://dx.doi.org/10.1371/journal.pone.0187363 Wang, J, Hodes, G E, Zhang, H, Epigenetic modulation of inflammation and synaptic plasticity promotes resilience against stress in mice, Nature Communications, 2018, 9, 1, 477, 477 Mitchell, K S, Am, D, Dimartino, D M, A pilot study of a randomized controlled trial of yoga as an intervention for PTSD symptoms in women, J Trauma Stress, 2014, 27, 2, 121, 129 Motraghi, Terri E., Seim, Richard W., Meyer, Eric C., Morissette, Sandra B., Virtual Reality Exposure Therapy for the Treatment of Posttraumatic Stress Disorder: A Methodological Review Using CONSORT Guidelines, Journal of Clinical Psychology, 2014, 70, 3, 197, 208, 0021-9762, 10.1002/jclp.22051, Wiley, https://dx.doi.org/10.1002/jclp.22051 Regev, Dafna, Cohen-Yatziv, Liat, Effectiveness of Art Therapy With Adult Clients in 2018—What Progress Has Been Made?, Frontiers in Psychology, 2018, 9, 1664-1078, 10.3389/fpsyg.2018.01531, Frontiers Media SA, https://dx.doi.org/10.3389/fpsyg.2018.01531