Effectiveness of metacognitive interventions for mental disorders in adults—A systematic review and meta‐analysis (METACOG)
Abstract
We evaluated the effectiveness and acceptability of metacognitive interventions for mental disorders. We searched electronic databases and included randomized and nonrandomized controlled trials comparing metacognitive interventions with other treatments in adults with mental disorders. Primary effectiveness and acceptability outcomes were symptom severity and dropout, respectively. We performed random‐effects meta‐analyses. We identified Metacognitive Training (MCTrain), Metacognitive Therapy (MCTherap), and Metacognition Reflection and Insight Therapy (MERIT). We included 49 trials with 2,609 patients. In patients with schizophrenia, MCTrain was more effective than a psychological treatment (cognitive remediation, SMD = −0.39). It bordered significance when compared with standard or other psychological treatments. In a post hoc analysis, across all studies, the pooled effect was significant (SMD = −0.31). MCTrain was more effective than standard treatment in patients with obsessive–compulsive disorder (SMD = −0.40). MCTherap was more effective than a waitlist in patients with depression (SMD = −2.80), posttraumatic stress disorder (SMD = −2.36), and psychological treatments (cognitive–behavioural) in patients with anxiety (SMD = −0.46). In patients with depression, MCTherap was not superior to psychological treatment (cognitive–behavioural). For MERIT, the database was too small to allow solid conclusions. Acceptability of metacognitive interventions among patients was high on average. Methodological quality was mostly unclear or moderate. Metacognitive interventions are likely to be effective in alleviating symptom severity in mental disorders. Although their add‐on value against existing psychological interventions awaits to be established, potential advantages are their low threshold and economy.
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A recent meta-analysis showed an effect size of SMD = 0.40 for myMCT.
“A recent meta-analysis showed an effect size of SMD = 0.40 [47].”
From Metacognitive Training for Obsessive-Compulsive Disorder: A study protocol for a randomized controlled trial (2020) · cites this paper as [47]
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Self-citation
- Authors
- Philipp, R., Kriston, L., Lanio, J., Kühne, F., Härter, M., Moritz, S., & Meister, R.
- Affiliations
- University Medical Center Hamburg-Eppendorf (DE)
- University of Potsdam (DE)
- Corresponding author
- Philipp, Rebecca
- Venue
- Clinical Psychology & Psychotherapy
- Publisher
- Wiley
- Published
- 2018-12-16
- Volume
- 26
- Issue
- 2
- Pages
- 227-240
- ISSN
- 1063-3995 (ISSN-L)
- 1099-0879
- OpenAlex
- W2901727566
- Cited by
- 114
- References
- 76
- Citations by year
- 2026: 13 · 2025: 15 · 2024: 12 · 2023: 16 · 2022: 14 · 2021: 17 · 2020: 16 · 2019: 11
- FWCI
- 1.75
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Clinical Psychology & Psychotherapy (publishedVersion)
- PubMed (publishedVersion)
- publish.UP (University of Potsdam) (submittedVersion)
- Funders
- Bundesministerium für Bildung und Forschung
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Keywords
- metacognitive intervention, metacognitive therapy, metacognitive training, mental illness, schizophrenia, obsessive-compulsive disorder, depression, post-traumatic stress disorder, anxiety, symptom severity, treatment discontinuation, acceptability, cognitive remediation, cognitive behavioral therapy
- MeSH terms
- Metacognition, Adult, Mental Disorders, Humans, Treatment Outcome, Patient Satisfaction
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