Sustained antipsychotic effect of metacognitive training in psychosis: A randomized-controlled study

Abstract

Persistent psychotic symptoms represent a major challenge for psychiatric care. Basic research has shown that psychotic symptoms are associated with cognitive biases. Metacognitive training (MCT) aims at helping patients to become aware of these biases and to improve problem-solving. Fifty-two participants fulfilling diagnostic criteria of schizophrenia or schizoaffective disorders and persistent delusions and stabilized antipsychotic medication were enrolled in this study. Following baseline assessment patients were randomized either to treatment as usual (TAU) conditions or TAU+MCT. The intervention consisted of eight weekly 1-hour sessions (maximum: 8 hours). Participants were assessed at 8 weeks and 6-months later by blind assessors. Participants were assessed with the Psychotic Symptoms Rating Scales (PSYRATS) and the positive subscale of the PANSS. Between-group differences in post- and pre-test values were significant at a medium effect size in favor of the MCT for the PSYRATS delusion scale and the positive scale of the PANSS both at post and follow-up. The results of this study indicate that MCT training has a surplus antipsychotic effect for patients suffering from schizophrenia-related disorders who demonstrate only a partial response to antipsychotic treatment and that the effect of the intervention persists for at least 6 months after the intervention.

Decreasing self-reported cognitive biases and increasing clinical insight through meta-cognitive training in patients with chronic schizophrenia

“…The effects of MCT on particular symptom severity, especially delusions, may be considered lower than those obtained from some of the previous studies that were conducted among younger patients (Balzan et al, 2015;Favrod et al, 2014;Moritz et al, 2013). Still, the effects of MCT in our sample were in the range of the results of other studies that had been conducted among younger patients (Aghotor et al, 2010;Moritz, Kerstan, et al, 2011); however, it should be noted that our results are statistically insignificant.…”

“…A number of studies have shown that MCT significantly reduces cognitive biases and improves positive symptoms (Aghotor, Pfueller, Moritz, Weisbrod, & Roesch-Ely, 2010;Balzan, Delfabbro, Galletly, & Woodward, 2015;Favrod et al, 2014; for a review see: Moritz, Kerstan, et al, 2011;Moritz, Veckenstedt et al, 2014;Moritz et al, 2013;Moritz, Veckenstedt, Randjbar, Vitzthum, & Woodward, 2011), with only one exception to date (van Oosterhout et al, 2014). Some studies have also shown that MCT increases clinical insight among patients with schizophrenia (Favrod et al, 2014).…”

“…Some studies have also shown that MCT increases clinical insight among patients with schizophrenia (Favrod et al, 2014). Therapeutic changes after MCT persist over at least a 6-month follow-up period (Favrod et al, 2014;Moritz et al, 2013), or even gradually increase during a 3-year follow-up period (Moritz, Veckenstedt, et al, 2014).…”

Individualized metacognitive therapy for delusions: A randomized controlled rater-blind study

“…It is probable that this inconsistency is due to selective floor effects in the MCT+ group: As shown in Tables 1 and 2, the randomization process resulted in differences between the two groups regarding baseline symptoms, which were lower in MCT+ patients -and, in fact, lower than in previous studies by our group (Moritz et al, 2013a;Moritz et al, 2011) and others (Favrod et al, 2014;So et al, 2015). This, in combination with the rapid improvement, led to very low symptom levels in these patients post-intervention, while the control group may have benefited from greater margins for change.…”

High estradiol levels improve false memory rates and meta-memory in highly schizotypal women

“…It has been suggested, though, that delusions are underpinned, at least in part, by a general susceptibility to forming false beliefs/memories with a high level of confidence (Laws and Bhatt, 2005;. Therefore, investigating the factors influencing confidence in false memories could be of high clinical relevance by improving an understanding of the development and maintenance of delusions, and by potentially influencing individual treatment options for schizophrenia (Favrod et al, 2014; for a review, see Moritz et al, 2014).…”