S Ochoa1, R López-Carrilero1, M L Barrigón2, E Pousa3, A Barajas4, E Lorente-Rovira3, F González-Higueras5, E Grasa3, I Ruiz-Delgado6, J Cid7, I Birulés1, I Esteban-Pinos8, R Casañas4, A Luengo3, P Torres-Hernández5, I Corripio3, M Montes-Gámez6, M Beltran7, A De Apraiz1, L Domínguez-Sánchez9, E Sánchez4, B Llacer3, T Pélaez1, J L Bogas1, S Moritz10. 1. Parc Sanitari Sant Joan de Déu,Sant Boi de Llobregat, Barcelona,Spain. 2. Department of Psychiatry,IIS-Fundación Jiménez Díaz Hospital,Madrid,Spain. 3. Investigación Biomédica en Red de Salud Mental, CIBERSAM,Madrid,Spain. 4. Centre d'Higiene Mental Les Corts,Barcelona,Spain. 5. Comunidad Terapéutica Jaén Servicio Andaluz de Salud,Jaén,Spain. 6. Unidad de Salud Mental Comunitaria Malaga Norte, UGC Salud Mental Carlos Haya,Servicio Andaluz de Salud Málaga,Spain. 7. Mental Health & Addiction Research Group, IdiBGi. Institut d'Assistencia Sanitària,Girona,Spain. 8. Psychiatry Service, Area de Gestión Sanitaria Sur Granada,Motril,Granada,Spain. 9. Psychiatry Service, Area de Gestión Sanitaria Norte de Málaga,Antequera,Málaga,Spain. 10. Department of Psychiatry and Psychotherapy,University Medical Center Hamburg,Hamburg,Germany.
Abstract
BACKGROUND: Aims were to assess the efficacy of metacognitive training (MCT) in people with a recent onset of psychosis in terms of symptoms as a primary outcome and metacognitive variables as a secondary outcome. METHOD: A multicenter, randomized, controlled clinical trial was performed. A total of 126 patients were randomized to an MCT or a psycho-educational intervention with cognitive-behavioral elements. The sample was composed of people with a recent onset of psychosis, recruited from nine public centers in Spain. The treatment consisted of eight weekly sessions for both groups. Patients were assessed at three time-points: baseline, post-treatment, and at 6 months follow-up. The evaluator was blinded to the condition of the patient. Symptoms were assessed with the PANSS and metacognition was assessed with a battery of questionnaires of cognitive biases and social cognition. RESULTS: Both MCT and psycho-educational groups had improved symptoms post-treatment and at follow-up, with greater improvements in the MCT group. The MCT group was superior to the psycho-educational group on the Beck Cognitive Insight Scale (BCIS) total (p = 0.026) and self-certainty (p = 0.035) and dependence self-subscale of irrational beliefs, comparing baseline and post-treatment. Moreover, comparing baseline and follow-up, the MCT group was better than the psycho-educational group in self-reflectiveness on the BCIS (p = 0.047), total BCIS (p = 0.045), and intolerance to frustration (p = 0.014). Jumping to Conclusions (JTC) improved more in the MCT group than the psycho-educational group (p = 0.021). Regarding the comparison within each group, Theory of Mind (ToM), Personalizing Bias, and other subscales of irrational beliefs improved in the MCT group but not the psycho-educational group (p < 0.001-0.032). CONCLUSIONS:MCT could be an effective psychological intervention for people with recent onset of psychosis in order to improve cognitive insight, JTC, and tolerance to frustration. It seems that MCT could be useful to improve symptoms, ToM, and personalizing bias.
RCT Entities:
BACKGROUND: Aims were to assess the efficacy of metacognitive training (MCT) in people with a recent onset of psychosis in terms of symptoms as a primary outcome and metacognitive variables as a secondary outcome. METHOD: A multicenter, randomized, controlled clinical trial was performed. A total of 126 patients were randomized to an MCT or a psycho-educational intervention with cognitive-behavioral elements. The sample was composed of people with a recent onset of psychosis, recruited from nine public centers in Spain. The treatment consisted of eight weekly sessions for both groups. Patients were assessed at three time-points: baseline, post-treatment, and at 6 months follow-up. The evaluator was blinded to the condition of the patient. Symptoms were assessed with the PANSS and metacognition was assessed with a battery of questionnaires of cognitive biases and social cognition. RESULTS: Both MCT and psycho-educational groups had improved symptoms post-treatment and at follow-up, with greater improvements in the MCT group. The MCT group was superior to the psycho-educational group on the Beck Cognitive Insight Scale (BCIS) total (p = 0.026) and self-certainty (p = 0.035) and dependence self-subscale of irrational beliefs, comparing baseline and post-treatment. Moreover, comparing baseline and follow-up, the MCT group was better than the psycho-educational group in self-reflectiveness on the BCIS (p = 0.047), total BCIS (p = 0.045), and intolerance to frustration (p = 0.014). Jumping to Conclusions (JTC) improved more in the MCT group than the psycho-educational group (p = 0.021). Regarding the comparison within each group, Theory of Mind (ToM), Personalizing Bias, and other subscales of irrational beliefs improved in the MCT group but not the psycho-educational group (p < 0.001-0.032). CONCLUSIONS: MCT could be an effective psychological intervention for people with recent onset of psychosis in order to improve cognitive insight, JTC, and tolerance to frustration. It seems that MCT could be useful to improve symptoms, ToM, and personalizing bias.
Authors: Paul H Lysaker; Michelle L Pattison; Bethany L Leonhardt; Scott Phelps; Jenifer L Vohs Journal: World Psychiatry Date: 2018-02 Impact factor: 49.548
Authors: Giada Tripoli; Diego Quattrone; Laura Ferraro; Charlotte Gayer-Anderson; Victoria Rodriguez; Caterina La Cascia; Daniele La Barbera; Crocettarachele Sartorio; Fabio Seminerio; Ilaria Tarricone; Domenico Berardi; Andrei Szöke; Celso Arango; Andrea Tortelli; Pierre-Michel Llorca; Lieuwe de Haan; Eva Velthorst; Julio Bobes; Miguel Bernardo; Julio Sanjuán; Jose Luis Santos; Manuel Arrojo; Cristina Marta Del-Ben; Paulo Rossi Menezes; Jean-Paul Selten; Peter B Jones; Hannah E Jongsma; James B Kirkbride; Antonio Lasalvia; Sarah Tosato; Alex Richards; Michael O'Donovan; Bart Pf Rutten; Jim van Os; Craig Morgan; Pak C Sham; Robin M Murray; Graham K Murray; Marta Di Forti Journal: Psychol Med Date: 2020-04-24 Impact factor: 7.723