Metacognitive training shows promising outcomes in psychosis cases, JAMA says

Canada: In a new study published in JAMA Psychiatry it was seen that in numerous treatment situations, metacognitive training (MCT) for psychosis was related to effects up to one year after the intervention.

A significant rise in the number of studies evaluating metacognitive training for psychosis needs an updated assessment of the outcomes related to MCT. As a result, Danielle Penney and colleagues conducted this study to examine the instant and maintained associations of MCT with proximal and distal outcomes, as well as to assess treatment- and participant-related moderators to identify potential factors associated with the expected heterogeneity of effect sizes.

From 2007 until June 3, 2021, eleven electronic databases were searched (alert until September 10, 2021). The reference lists of previous meta-analyses and included publications were sifted through. MCT was studied in reports, and patients with schizophrenia spectrum illness and similar psychotic disorders were included (1045 reports identified; 281 assessed). There were no constraints on age, gender, race & ethnicity, language, or research design. The studies to be evaluated were chosen by two reviewers. Global pleasant symptoms, hallucinations, delusions, and cognitive biases were the proximal results. Self-esteem, quality of life, negative symptoms, well-being, and functioning were the distal outcomes. Immediate and long-term consequences were investigated. Moderators were investigated using meta-regressions, subgroup, and sensitivity analyses.

The key findings of this study were as follow:

1. This meta-analysis and systematic review includes 43 papers (46 reports).

2. In the meta-analysis (N=1816 individuals), forty studies were synthesized, and six reports were included in the narrative review.

3. MCT was linked to positive symptoms, hallucinations, delusions, cognitive biases, negative symptoms, self-esteem, and functioning in the trials reviewed.

4. These relationships were kept for a year.

5. The size of the quality of life effect was insignificant; only one research measured well-being.

6. The year of publication was linked to mild hallucinations. Overall, the findings of the narrative review confirmed the findings of the meta-analysis.

In conclusion, the outcomes of this comprehensive study and meta-analysis reveal that MCT is a useful and long-lasting low-threshold intervention that may be administered flexibly and at little cost in a number of venues to people suffering from psychotic illnesses.

Reference:

Penney D, Sauvé G, Mendelson D, Thibaudeau É, Moritz S, Lepage M. Immediate and Sustained Outcomes and Moderators Associated With Metacognitive Training for Psychosis: A Systematic Review and Meta-analysis. JAMA Psychiatry. Published online March 23, 2022. doi:10.1001/jamapsychiatry.2022.0277