Cognitive deficits are a core feature of mental and behavioral disorders, leading to poor treatment adherence and functionality. Virtual reality (VR) methodologies are promising solutions for cognitive interventions in psychiatry once they provide greater ecological validity. This study assessed and compared two content-equivalent cognitive training (CT) interventions, delivered in desktop VR (Reh@City v2.0) and paper-and-pencil (Task Generator (TG)) formats, in patients with mental and behavioral disorders. 30 patients were randomly assigned to the Reh@City v2.0 group and the TG group. Both groups of patients underwent a time-matched 24-sessions intervention. Neuropsychological assessments were performed at baseline, post-intervention, and follow-up. A within-groups analysis revealed significant improvements in visual memory and depressive symptomatology after the Reh@City intervention. The TG group improved in processing speed, verbal memory, and quality of life (social relationships and environmental domains). Between groups, Reh@City led to a greater reduction in depressive symptomatology, whereas the TG group showed higher improvements in social relationships aspects of quality of life. At follow-up, previous gains were maintained and new improvements found in the Reh@City (global cognitive function, language, visuospatial and executive functions) and the TG groups (attention). The Reh@City significantly reduced depressive symptomatology, and the TG led to greater improvements in processing speed, abstraction, and social relationships domain of quality of life at follow-up. Both interventions were associated with important cognitive, emotional, and quality of life benefits, which were maintained after two months. Reh@City and TG should be considered as complementary CT methods for patients with mental and behavioral disorders.

Trial registration The trial is registered at ClinicalTrials.gov, number NCT04291586.

认知缺陷是精神和行为障碍的核心特征，导致治疗依从性和功能不佳。虚拟现实 (VR) 方法一旦提供更大的生态有效性，就会成为精神病学认知干预的有前途的解决方案。本研究评估并比较了两种内容等效的认知训练 (CT) 干预措施，这些干预措施以桌面 VR (Reh@City v2.0) 和纸笔（任务生成器 (TG)）格式在精神和行为障碍患者中进行. 30 名患者被随机分配到 Reh@City v2.0 组和 TG 组。两组患者均接受了时间匹配的 24 次干预。在基线、干预后和随访时进行神经心理学评估。组内分析显示在 Reh@City 干预后视觉记忆和抑郁症状有显着改善。TG 组在处理速度、语言记忆和生活质量（社会关系和环境领域）方面都有所提高。在组之间，Reh@City 导致抑郁症状的减少更多，而 TG 组在生活质量的社会关系方面表现出更高的改善。在后续行动中，之前的成果得以保持，并在 Reh@City（全球认知功能、语言、视觉空间和执行功能）和 TG 组（注意力）中发现了新的改进。Reh@City 显着减少了抑郁症状，而 TG 导致后续处理速度、抽象和社会关系领域的生活质量有了更大的改善。两种干预措施都与重要的认知、情感和生活质量益处相关，这些益处在两个月后得以维持。Reh@City 和 TG 应被视为精神和行为障碍患者的互补 CT 方法。

试验注册试验在 ClinicalTrials.gov 注册，编号 NCT04291586。