Randomized control trial to assess the efficacy of metacognitive training compared with a psycho-educational group in people with a recent-onset psychosis
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.
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Compared to psychoeducation, metacognitive training improved several facets related to reasoning style.
“Ochoa et al 182 compared the effects of MCT to psychoeducation and found a positive impact on the self-reflection component of cognitive insight along with improvement in several facets related to reasoning style.”
From Insight in schizophrenia spectrum disorders: relationship with behavior, mood and perceived quality of life, underlying causes and emerging treatments (2018) · cites this paper as [182]
Compared to psychoeducation, metacognitive training had a positive impact on the self-reflection component of cognitive insight.
“Ochoa et al 182 compared the effects of MCT to psychoeducation and found a positive impact on the self-reflection component of cognitive insight along with improvement in several facets related to reasoning style.”
From Insight in schizophrenia spectrum disorders: relationship with behavior, mood and perceived quality of life, underlying causes and emerging treatments (2018) · cites this paper as [182]
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- Authors
- Ochoa, S., López-Carrilero, R., Barrigón, M. L., Pousa, E., Barajas, A., Lorente-Rovira, E., González-Higueras, F., Grasa, E., Ruiz-Delgado, I., Cid, J., Birulés, I., Esteban-Pinos, I., Casañas, R., Luengo, A., Torres-Hernández, P., Corripio, I., Montes-Gámez, M., Beltran, M., De Apraiz, A., Domínguez-Sánchez, L., Sánchez, E., Llacer, B., Pélaez, T., Bogas, J. L., Moritz, S., & the Spanish Metacognition Study Group
- Affiliations
- Centro de Investigación Biomédica en Red de Salud Mental (ES)
- Hospital Universitario Fundación Jiménez Díaz (ES)
- Universitat Autònoma de Barcelona (ES)
- Institut d'Assistència Sanitària (ES)
- Centre d'Higiene Mental Les Corts (Spain) (ES)
- Andalusian Health Service (ES)
- Parc Sanitari Sant Joan de Déu (ES)
- Universität Hamburg (DE)
- Corresponding author
- Ochoa, S.
- ORCID
- Venue
- Psychological Medicine
- Publisher
- Cambridge University Press (CUP)
- Published
- 2017-02-07
- Volume
- 47
- Issue
- 9
- Pages
- 1573-1584
- ISSN
- 0033-2917 (ISSN-L)
- 1469-8978
- OpenAlex
- W2587661792
- Cited by
- 97
- References
- 63
- Citations by year
- 2026: 8 · 2025: 16 · 2024: 8 · 2023: 8 · 2022: 14 · 2021: 13 · 2020: 12 · 2019: 12 · 2018: 4 · 2017: 2
- FWCI
- 6.73
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Psychological Medicine (publishedVersion)
- PubMed (publishedVersion)
- Funders
- “la Caixa” Foundation
- Instituto de Salud Carlos III
- European Regional Development Fund
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Social Sciences › Psychology › Clinical Psychology › Psychological Treatments and Assessments
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Keywords
- metacognitive training, recent-onset psychosis, first-episode psychosis, psychoeducational intervention, cognitive insight, cognitive biases, jumping to conclusions, theory of mind, irrational beliefs, self-certainty, social cognition, symptom relief
- MeSH terms
- Metacognition, Cognitive Remediation, Adult, Female, Follow-Up Studies, Humans, Male, Psychotic Disorders, Thinking, Cognitive Behavioral Therapy, Single-Blind Method, Outcome Assessment, Health Care, Young Adult, Theory of Mind
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