Lara Manuela Guedes de Pinho1,2,3, Carlos Alberto da Cruz Sequeira4,5, Francisco Miguel Correia Sampaio5,6, Nuno Barbosa Rocha7, Zeynep Ozaslan8,9, Carmen Ferre-Grau3. 1. University of Évora, Évora, Portugal. 2. Comprehensive Health Research Centre (CHRC), Évora, Portugal. 3. Universitat Rovira and Virgili, Tarragona, Spain. 4. School of Nursing of Porto, Porto, Portugal. 5. NursID - Innovation & Development in Nursing Research Group, CINTESIS - Center for Health Technology and Services Research, Porto, Portugal. 6. Higher School of Health of the Instituto Politécnico de Portalegre, Porto, Portugal. 7. School of Health, Polytechnic of Porto, Porto, Portugal. 8. Faculty of Health Sciences, Kocaeli University, Kocaeli, Turkey. 9. Postdoctoral Scholar at the University of Michigan School of Nursing, Ann Arbor, MI, USA.
Abstract
AIM: To evaluate the efficacy of metacognitive group training in reducing psychotic symptoms and improving cognitive insight and functions in people with schizophrenia. DESIGN: Randomized controlled trial. It was carried out between July 2019 -February 2020. METHODS:Fifty-six patients with schizophrenia were enrolled and randomly assigned to either a control group (N = 29) or a metacognitive training group (N = 27). Blinded assessments were made at baseline, 1-week post-treatment and at follow-up 3 months after treatment. The primary outcome measure was psychotic symptoms based on the Psychotic Symptom Rating Scales (PSYRATS). Secondary outcomes were assessed by the Beck Cognitive Insight Scale (BCIS), the Personal and Social Performance (PSP) scale and the World Health Organization Disability Assessment Schedule (WHODAS). RESULTS: Completion at follow-up was high (92.86%). The intention-to-treat analyses demonstrated that patients in the metacognitive training group had significantly greater improvements of the Psychotic Symptom Rating Scales delusion score and total score and the Personal and Social Performance Scale, after 3 months, compared with the control group. The effect size was medium to large. The intention-to-treat analyses also demonstrated that patients in the metacognitive training group had significantly greater reductions of the Psychotic Symptom Rating Scales hallucination score and Beck Cognitive Insight Scale self-certainty score post-treatment, compared with the control group. The effect size was medium to large. CONCLUSION: The metacognitive training administered by psychiatric and mental health nurses was effective in ameliorating delusions and social functioning over time and it immediately reduced hallucinations post-treatment. IMPACT: Metacognitive training for treating psychosis in patients with schizophrenia is efficacious and administration is clinically feasible in the Portuguese context. TRIAL REGISTRATION NUMBER: ClinicalTrials.gov ID NCT03891186.
RCT Entities:
AIM: To evaluate the efficacy of metacognitive group training in reducing psychotic symptoms and improving cognitive insight and functions in people with schizophrenia. DESIGN: Randomized controlled trial. It was carried out between July 2019 -February 2020. METHODS: Fifty-six patients with schizophrenia were enrolled and randomly assigned to either a control group (N = 29) or a metacognitive training group (N = 27). Blinded assessments were made at baseline, 1-week post-treatment and at follow-up 3 months after treatment. The primary outcome measure was psychotic symptoms based on the Psychotic Symptom Rating Scales (PSYRATS). Secondary outcomes were assessed by the Beck Cognitive Insight Scale (BCIS), the Personal and Social Performance (PSP) scale and the World Health Organization Disability Assessment Schedule (WHODAS). RESULTS: Completion at follow-up was high (92.86%). The intention-to-treat analyses demonstrated that patients in the metacognitive training group had significantly greater improvements of the Psychotic Symptom Rating Scales delusion score and total score and the Personal and Social Performance Scale, after 3 months, compared with the control group. The effect size was medium to large. The intention-to-treat analyses also demonstrated that patients in the metacognitive training group had significantly greater reductions of the Psychotic Symptom Rating Scales hallucination score and Beck Cognitive Insight Scale self-certainty score post-treatment, compared with the control group. The effect size was medium to large. CONCLUSION: The metacognitive training administered by psychiatric and mental health nurses was effective in ameliorating delusions and social functioning over time and it immediately reduced hallucinations post-treatment. IMPACT: Metacognitive training for treating psychosis in patients with schizophrenia is efficacious and administration is clinically feasible in the Portuguese context. TRIAL REGISTRATION NUMBER: ClinicalTrials.gov ID NCT03891186.