Metacognitive training for schizophrenia: A multicentre randomised controlled trial

Briki, Malick; Monnin, Julie; Haffen, Emmanuel; Sechter, D.; Favrod, Jérôme; Netillard, Christian; Cheraitia, Elisabeth; Marin, Karine; Govyadovskaya, Svetlana; Tio, Grégory; Bonin, Bernard; Chauvet-Gélinier, Jean-Christophe; Leclerc, Stéphanie; Hodé, Yann; Vidailhet, P.; Berna, Fabrice; Bertschy, A. Zinetti; Vandel, Pierre

doi:10.1016/j.schres.2014.06.005

Cited by 49 publications

(41 citation statements)

References 39 publications

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“…These trials provided comparisons of the following psychological treatments: CBT (N=40), metacognitive training (N=6), mindfulness (N=2), acceptance and commitment therapy (N=2), experience focused counselling (N=1), hallucination focused integrative treatment (N=1), and AVATAR therapy (N=1).…”

Section: Resultsmentioning

confidence: 99%

Psychological interventions to reduce positive symptoms in schizophrenia: systematic review and network meta‐analysis

et al. 2018

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Psychological treatments are increasingly regarded as useful interventions for schizophrenia. However, a comprehensive evaluation of the available evidence is lacking and the benefit of psychological interventions for patients with current positive symptoms is still debated. The present study aimed to evaluate the efficacy, acceptability and tolerability of psychological treatments for positive symptoms of schizophrenia by applying a network meta-analysis approach, that can integrate direct and indirect comparisons. We searched EMBASE, MEDLINE, PsycINFO, PubMed, BIOSIS, Cochrane Library, World Health Organization's International Clinical Trials Registry Platform and ClinicalTrials.gov for randomized controlled trials of psychological treatments for positive symptoms of schizophrenia, published up to January 10, 2018. We included studies on adults with a diagnosis of schizophrenia or a related disorder presenting positive symptoms. The primary outcome was change in positive symptoms measured with validated rating scales. We included 53 randomized controlled trials of seven psychological interventions, for a total of 4,068 participants receiving the psychological treatment as add-on to antipsychotics. On average, patients were moderately ill at baseline. The network meta-analysis showed that cognitive behavioural therapy (40 studies) reduced positive symptoms more than inactive control (standardized mean difference, SMD=-0.29; 95% CI: -0.55 to -0.03), treatment as usual (SMD=-0.30; 95% CI: -0.45 to -0.14) and supportive therapy (SMD=-0.47; 95% CI: -0.91 to -0.03). Cognitive behavioural therapy was associated with a higher dropout rate compared with treatment as usual (risk ratio, RR=0.74; 95% CI: 0.58 to 0.95). Confidence in the estimates ranged from moderate to very low. The other treatments contributed to the network with a lower number of studies. Results were overall consistent in sensitivity analyses controlling for several factors, including the role of researchers' allegiance and blinding of outcome assessor. Cognitive behavior therapy seems to be effective on positive symptoms in moderately ill patients with schizophrenia, with effect sizes in the lower to medium range, depending on the control condition.

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Section: Resultsmentioning

confidence: 99%

Psychological interventions to reduce positive symptoms in schizophrenia: systematic review and network meta‐analysis

et al. 2018

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“…However, Briki et al 180 reported that, relative to treatment as usual, MCT led to improvements only at a trend level.…”

Section: Metacognitive Training Can Affect Insightmentioning

confidence: 99%

Insight in schizophrenia spectrum disorders: relationship with behavior, mood and perceived quality of life, underlying causes and emerging treatments

et al. 2018

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Poor insight in schizophrenia is prevalent across cultures and phases of illness. In this review, we examine the recent research on the relationship of insight with behavior, mood and perceived quality of life, on its complex roots, and on the effects of existing and emerging treatments. This research indicates that poor insight predicts poorer treatment adherence and therapeutic alliance, higher symptom severity and more impaired community function, while good insight predicts a higher frequency of depression and demoralization, especially when coupled with stigma and social disadvantage. This research also suggests that poor insight may arise in response to biological, experiential, neuropsychological, social-cognitive, metacognitive and socio-political factors. Studies of the effects of existing and developing treatments indicate that they may influence insight. In the context of earlier research and historical models, these findings support an integrative model of poor insight. This model suggests that insight requires the integration of information about changes in internal states, external circumstances, others' perspectives and life trajectory as well as the multifaceted consequences and causes of each of those changes. One implication is that treatments should, beyond providing education, seek to assist persons with schizophrenia to integrate the broad range of complex and potentially deeply painful experiences which are associated with mental illness into their own personally meaningful, coherent and adaptive picture.

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“…Social cognition includes a number of components such as Theory of Mind (ToM), Affect Recognition, and Attributional Style [53]. The second process which may be related to insight is metacognition [77][78][79][80]. Metacognition refers to activities which allow persons to be aware of and form integrated and complex ideas about the self and others.…”

Section: Deficits In Social Cognition and Poor Metacognitionmentioning

confidence: 99%

An integrative model of the impairments in insight in schizophrenia: emerging research on causal factors and treatments

Vohs

George

Leonhardt

et al. 2016

Expert Review of Neurotherapeutics

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Introduction: Poor insight, or unawareness of some major aspect of mental illness, is a major barrier to wellness when it interferes with persons seeking out treatment or forming their own understanding of the challenges they face. One barrier to addressing impaired insight is the absence of a comprehensive model of how poor insight develops. Areas covered: To explore this issue we review how poor insight is the result of multiple phenomena which interfere with the construction of narrative accounts of psychiatric challenges, rather than a single social or biological cause.Expert Commentary: We propose an integrative model of poor insight in schizophrenia which involves the interaction of symptoms, deficits in neurocognition, social cognition, metacognition, and stigma. Emerging treatments for poor insight including therapies which focus on the development of metacognition are discussed.

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Metacognitive training for schizophrenia: A multicentre randomised controlled trial

Cited by 49 publications

References 39 publications

Psychological interventions to reduce positive symptoms in schizophrenia: systematic review and network meta‐analysis

Psychological interventions to reduce positive symptoms in schizophrenia: systematic review and network meta‐analysis

Insight in schizophrenia spectrum disorders: relationship with behavior, mood and perceived quality of life, underlying causes and emerging treatments

An integrative model of the impairments in insight in schizophrenia: emerging research on causal factors and treatments

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