The Use of Immersive Technologies to Identify and Manage Stress and Anxiety: A Systematic Review

Abstract

Stress and anxiety are among the most prevalent psychological conditions affecting individuals worldwide. Their impact has intensified since the COVID-19 pandemic, with projected economic consequences totaling up to US$ 6 trillion by 2030. In response, scientists are exploring new ways to detect and treat diseases, such as immersive technologies like virtual reality (VR), augmented reality (AR), and mixed reality (MR). This article presents a systematic review of the scientific literature published over the last decade on the application of immersive technologies to identify and manage stress and anxiety. The review encompasses 78 peer-reviewed studies and analyzes the type of immersive technology employed, the targeted condition (stress, anxiety, or both), the evaluation methods used, and the nature of the devices and interventions. The results reveal a strong dominance of VR-based systems, with moderate to high clinical adoption, but uneven adoption, and a clear dependence on self-reported psychological scales, such as STAI, PSS, and BAI. Although physiological data such as heart rate, electrodermal activity, and cortisol levels are used in a minority of studies, integrated behavioral metrics (eg, motor coordination or postural control) remain largely unexplored. This review highlights not only the growing potential of immersive technologies but also the scientific and clinical challenges that must be addressed, including integrating physiological and behavioral markers, ensuring usability and adaptability for diverse users, and establishing standardized protocols and long-term impact assessment. The findings offer a structured foundation for future research and development of immersive systems to support the detection and treatment of stress and anxiety