Efficacy of XRET in reducing anxiety symptoms and secondary effects on depression in adolescents with depressive disorder: a prospective non-randomized study

To explore the therapeutic effects of different doses of Extended Reality Exposure Therapy (XRET) combined with pharmacotherapy on anxiety and depressive symptoms in adolescents with depressive disorders, and to verify the dose-response relationship and advantages of this combined treatment. A total of 142 patients were divided into the high-dose group (n = 32), medium-dose group (n = 45), low-dose group (n = 32), and monotherapy group (n = 33). Repeated measures analysis of variance (ANOVA) was used to compare intra-group differences in symptom change scores (anxiety, depression) before and after the intervention. One-way ANOVA and LSD post-hoc correction were applied for inter-group comparisons. All four groups showed statistically significant improvements in anxiety and depressive symptoms after monotherapy or XRET-combined intervention (p < 0.001). The XRET dose groups demonstrated superior improvements in depression and anxiety symptoms compared to the monotherapy group (all p < 0.05). The medium-dose group exhibited the optimal improvement in depressive symptoms (ΔM = 16.16), which was significantly greater than that of the low-dose group (ΔM = 9.94; p < 0.001). There was also a statistically significant difference in depressive symptom improvement between the low-dose group and the high-dose group (ΔM = 13.97; p = 0.046), while no significant difference was observed between the medium-dose group and the high-dose group (p = 0.239). Regarding anxiety improvement, the difference between the low-dose group (ΔM = 9.75) and the medium-dose group (ΔM = 14.38) was statistically significant (p = 0.006). Extended Reality Exposure Therapy (XRET) combined with pharmacotherapy is effective in improving anxiety and depressive symptoms in adolescents with depressive disorders to a certain extent, with the medium-dose regimen yielding the optimal therapeutic benefit. Trial registration This study has been registered on the Chinese Clinical Trial Registry (Registration No.: ChiCTR2500099584)