The Efficacy of Extended Metacognitive Training on Neurocognitive Function in Schizophrenia: A Randomized Controlled Trial

Overview

Journal Brain Sci

Publisher MDPI

Date 2022 Mar 25

PMID 35326369

Authors

Can Wang

Yue Chong

Jiechun Zhang

Yili Cao

Yanbo Wang

Affiliations

Soon will be listed here.

Abstract

The aim of this study was to evaluate the effect of metacognitive training (MCT) on improving the neurocognitive function of Chinese patients with schizophrenia. One hundred inpatients with schizophrenia were selected by regional group randomization and divided into the control (treated as usual, TAU) group ( = 50) and the TAU + MCT group ( = 50). In this study, a 10-module MCT was used and the intervention process lasted 30 days. Cognitive function was assessed blindly using the Repeatable Battery of Neuropsychological Status (RBANS) scale at baseline, 24 h post-treatment, and 12 weeks' post-treatment. The differences between the total RBANS score and baseline (pre-test) for the post-test and 12-week-follow-up tests were used as the primary outcome, and the difference between the RBANS dimension scores and baseline (pre-test) were used as a secondary outcome in this study. The completion rate at follow-up was high in the TAU + MCT group (94%). Intention-to-treat analysis and per-protocol analysis showed a significant increase in total neurocognitive function scores and three-dimensional scores (delayed memory, visual breadth, and attention) in the TAU + MCT group immediately after the intervention and at the 12-week follow-up compared with baseline. This study provides support for the efficacy of 10 module MCT concerning neurocognition.

Citing Articles

THINC-Integrated Tool (THINC-it): A Brief Measurement of Changes in Cognitive Functioning and Its Correlation with the Life Quality of Patients with Schizophrenia and Related Disorders-A Pilot Study.

Szmyd J, Lewczuk K, Teopiz K, McIntyre R, Wichniak A Brain Sci. 2023; 13(3).

PMID: 36979199 PMC: 10046273. DOI: 10.3390/brainsci13030389.

References

Simon G, Stewart C, Yarborough B, Lynch F, Coleman K, Beck A . Mortality Rates After the First Diagnosis of Psychotic Disorder in Adolescents and Young Adults. JAMA Psychiatry. 2018; 75(3):254-260. PMC: 5885951. DOI: 10.1001/jamapsychiatry.2017.4437. View

Holthausen E, Wiersma D, Sitskoorn M, Dingemans P, Schene A, van den Bosch R . Long-term memory deficits in schizophrenia: primary or secondary dysfunction?. Neuropsychology. 2003; 17(4):539-47. DOI: 10.1037/0894-4105.17.4.539. View

Moritz S, Kerstan A, Veckenstedt R, Randjbar S, Vitzthum F, Schmidt C . Further evidence for the efficacy of a metacognitive group training in schizophrenia. Behav Res Ther. 2011; 49(3):151-7. DOI: 10.1016/j.brat.2010.11.010. View

Aghotor J, Pfueller U, Moritz S, Weisbrod M, Roesch-Ely D . Metacognitive training for patients with schizophrenia (MCT): feasibility and preliminary evidence for its efficacy. J Behav Ther Exp Psychiatry. 2010; 41(3):207-11. DOI: 10.1016/j.jbtep.2010.01.004. View

Bachman P, Reichenberg A, Rice P, Woolsey M, Chaves O, Martinez D . Deconstructing processing speed deficits in schizophrenia: application of a parametric digit symbol coding test. Schizophr Res. 2010; 118(1-3):6-11. PMC: 2900389. DOI: 10.1016/j.schres.2010.02.1029. View

Ishikawa R, Ishigaki T, Shimada T, Tanoue H, Yoshinaga N, Oribe N . The efficacy of extended metacognitive training for psychosis: A randomized controlled trial. Schizophr Res. 2019; 215:399-407. DOI: 10.1016/j.schres.2019.08.006. View

MacKenzie N, Kowalchuk C, Agarwal S, Costa-Dookhan K, Caravaggio F, Gerretsen P . Antipsychotics, Metabolic Adverse Effects, and Cognitive Function in Schizophrenia. Front Psychiatry. 2018; 9:622. PMC: 6290646. DOI: 10.3389/fpsyt.2018.00622. View

van der Gaag M, van den Berg D, Ising H . CBT in the prevention of psychosis and other severe mental disorders in patients with an at risk mental state: A review and proposed next steps. Schizophr Res. 2017; 203:88-93. DOI: 10.1016/j.schres.2017.08.018. View

McCutcheon R, Marques T, Howes O . Schizophrenia-An Overview. JAMA Psychiatry. 2019; 77(2):201-210. DOI: 10.1001/jamapsychiatry.2019.3360. View

10.

Murray R, Schaer M, Debbane M . Degrees of separation: a quantitative neuroimaging meta-analysis investigating self-specificity and shared neural activation between self- and other-reflection. Neurosci Biobehav Rev. 2012; 36(3):1043-59. DOI: 10.1016/j.neubiorev.2011.12.013. View

11.

de Pinho L, Sequeira C, Sampaio F, Rocha N, Ozaslan Z, Ferre-Grau C . Assessing the efficacy and feasibility of providing metacognitive training for patients with schizophrenia by mental health nurses: A randomized controlled trial. J Adv Nurs. 2020; 77(2):999-1012. DOI: 10.1111/jan.14627. View

12.

Moritz S, Veckenstedt R, Bohn F, Hottenrott B, Scheu F, Randjbar S . Complementary group Metacognitive Training (MCT) reduces delusional ideation in schizophrenia. Schizophr Res. 2013; 151(1-3):61-9. DOI: 10.1016/j.schres.2013.10.007. View

13.

Owen M, Sawa A, Mortensen P . Schizophrenia. Lancet. 2016; 388(10039):86-97. PMC: 4940219. DOI: 10.1016/S0140-6736(15)01121-6. View

14.

Plana-Ripoll O, Pedersen C, Agerbo E, Holtz Y, Erlangsen A, Canudas-Romo V . A comprehensive analysis of mortality-related health metrics associated with mental disorders: a nationwide, register-based cohort study. Lancet. 2019; 394(10211):1827-1835. DOI: 10.1016/S0140-6736(19)32316-5. View

15.

Simon-Exposito M, Felipe-Castano E . Effects of Metacognitive Training on Cognitive Insight in a Sample of Patients with Schizophrenia. Int J Environ Res Public Health. 2019; 16(22). PMC: 6888430. DOI: 10.3390/ijerph16224541. View

16.

Ochoa S, Haro J, Huerta-Ramos E, Cuevas-Esteban J, Stephan-Otto C, Usall J . Relation between jumping to conclusions and cognitive functioning in people with schizophrenia in contrast with healthy participants. Schizophr Res. 2014; 159(1):211-7. DOI: 10.1016/j.schres.2014.07.026. View

17.

Montemagni C, Del Favero E, Riccardi C, Canta L, Toye M, Zanalda E . Effects of Cognitive Remediation on Cognition, Metacognition, and Social Cognition in Patients With Schizophrenia. Front Psychiatry. 2021; 12:649737. PMC: 8299002. DOI: 10.3389/fpsyt.2021.649737. View

18.

Gonzalez-Blanch C, Birules I, Pousa E, Barrigon M, Lopez-Carrilero R, Lorente-Rovira E . Moderators of cognitive insight outcome in metacognitive training for first-episode psychosis. J Psychiatr Res. 2021; 141:104-110. DOI: 10.1016/j.jpsychires.2021.06.040. View

19.

Fett A, Velthorst E, Reichenberg A, Ruggero C, Callahan J, Fochtmann L . Long-term Changes in Cognitive Functioning in Individuals With Psychotic Disorders: Findings From the Suffolk County Mental Health Project. JAMA Psychiatry. 2019; 77(4):387-396. PMC: 6990826. DOI: 10.1001/jamapsychiatry.2019.3993. View

20.

Moritz S, Woodward T . Metacognitive training in schizophrenia: from basic research to knowledge translation and intervention. Curr Opin Psychiatry. 2007; 20(6):619-25. DOI: 10.1097/YCO.0b013e3282f0b8ed. View