Objectives:
Virtual Reality (VR) has been widely used in psychiatry, including psychotic disorders. The main advantage of VR is its high ecological validity and controllability of the virtual environment. Our main goal was to test whether, similarly to computer-generated VR, 360-degree videos are able to elicit a state of social paranoia in prone individuals.

Methods:
Sixteen schizophrenia patients and twenty-three healthy individuals were assessed using Leibowitz Social Anxiety Scale and additionally, in the patient group, the Positive and Negative Syndrome Scale (PANSS–6) and Peters Delusional Inventory (PDI) were used. The participants viewed four 360-degree videos with and without social content on a VR headset. Meanwhile, subjects’ heart rate was measured continuously. After the exposure, both groups were assessed with Social State Paranoia Scale (SSPS) and asked about momentary anxiety and sense of presence.

Results:
The schizophrenia patients reported higher momentary anxiety, although the results of SSPS did not differ significantly between groups. In the control group the heart rate decreased between first non-social and social video, whereas in the patient group it did not differ significantly. There was a significant correlation of paranoid ideation experienced on daily basis (PDI) and elicited in VR (SSPS) in the patient group.

Conclusions:
In conclusion, paranoid responses can be triggered in patients with schizophrenia by 360-degree videos.