Integrative Biofeedback Therapy in a Treatment-Resistant Schizophrenia Case with Screen Addiction: Insights from qEEG and HRV

Excessive screen exposure in youth is increasingly recognized as a contributing factor in complex psychiatric presentations, often intertwined with developmental trauma and misdiagnosis within the schizophrenia spectrum. This case study presents the nine-month neurotherapy treatment of a 26-year-old male with a long-standing history of social withdrawal, obsessive-compulsive behaviors, and treatment resistance despite years of pharmacological and psychotherapeutic interventions. Early relational trauma, emotional neglect, and prolonged digital isolation were central elements in the clinical background. Pre- and post-intervention assessments included quantitative electroencephalography (qEEG), heart rate variability (HRV), and clinical observation. Biofeedback sessions were conducted weekly using a multimodal platform targeting autonomic regulation, attentional control, and cortical balance. Throughout therapy, a structured reduction in screen time was gradually implemented with the support of the caregiver. Following the intervention, qEEG data revealed significant neurophysiological changes, including reduced excessive theta and alpha power, normalization of alpha activity, interhemispheric asymmetry, and coherence. HRV metrics demonstrated increased vagal tone, improved sympathetic balance, and decreased physiological stress indices. These physiological shifts were accompanied by marked behavioral improvements: emotional re-engagement, renewed musical interest, increased humor and interaction, and improved ability to process written information. The case demonstrates that meaningful clinical change in screen-affected individuals requires more than symptom-based psychiatric diagnosis and medication. Neurotherapy combined with screen time regulation enabled a reversal of dissociative patterns and restored self-regulation. The findings support a trauma-informed, ecological model of care, where screen addictive behavior is seen as both a symptom and a therapeutic target. Addressing screen addiction is essential for achieving durable therapeutic outcomes in similar clinical profiles. Keywords: schizophrenia; screen addiction; trauma; treatment resistance; biofeedback; quantitative EEG (qEEG); heart rate variability (HRV); functional connectivity, coherence