Metacognitive training for psychosis (MCT): a systematic meta-review of its effectiveness.

IF 6.2 1区医学 Q1 PSYCHIATRY

Translational Psychiatry Pub Date : 2025-04-22 DOI:10.1038/s41398-025-03344-0

Antonia Meinhart, Geneviève Sauvé, Annika Schmueser, Danielle Penney, Fabrice Berna, Łukasz Gawęda, Maria Lamarca, Steffen Moritz, Susana Ochoa, Caroline König, Vanessa Acuña, Rabea Fischer

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引用次数: 0

Abstract

Objective: Metacognitive training for psychosis (MCT) targets cognitive biases implicated in the pathogenesis of psychosis, e.g., jumping to conclusions, overconfidence in errors, and inflexibility. This systematic meta-review investigated the current meta-analytic evidence for the effectiveness of MCT with respect to core symptom features in schizophrenia (i.e., positive symptoms, delusions and hallucinations, negative symptoms, and overall psychotic symptoms).

Data sources: This meta-review was registered with PROSPERO (CRD42023447442) on July 28, 2023. Articles were searched across five electronic databases from January 1, 2007 to September 1, 2023.

Study selection: Meta-analyses addressing metacognitive interventions targeting psychotic symptoms were eligible for meta-review.

Data extraction and synthesis: PRISMA guidelines were followed when applicable. Data extraction was done independently by two authors (AM, AS). A random-effects model was used to pool data within meta-analyses.

Main outcomes and measures: Main outcomes were levels/severity of positive symptoms, delusions and hallucinations, negative symptoms, and overall psychotic symptoms after intervention.

Results: Eight meta-analyses and two re-analyses were included for meta-review. A total of eight analyses provided sufficient data for analysis. Significant evidence was found in favor of MCT for positive symptoms (85.71%; N = 35, g = 0.473 [0.295, 0.651], I² = 74.64), delusions (60%; N = 24, g = 0.639 [0.389, 0.889], I² = 80.01), hallucinations (100%; N = 9, g = 0.265 [0.098, 0.432], I² = 6.1), negative symptoms (100%; N = 17, g = 0.233 [0.1, 0.366], I² = 34.78), and overall symptoms (50%; N = 37, g = 0.392 [0.245, 0.538], I² = 65.73). None of the meta-analyses included a large enough sample size to meet the criteria for 'suggestive', 'convincing', or 'highly convincing' evidence according to metaumbrella.org guidelines (required sample size > 1000 cases). None of the meta-analyses scored 'moderate' or 'high' on methodological quality. Meta-analyses with significant results were more recent and/or considered more primary studies.

Conclusions and relevance: There is consistent evidence that MCT ameliorates positive symptoms and delusions in schizophrenia.

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精神病的元认知训练（MCT）：对其有效性的系统元评价。

目的：精神病元认知训练（MCT）针对与精神病发病机制有关的认知偏差，如草率下结论、对错误过于自信和缺乏灵活性。本系统荟萃综述调查了MCT对精神分裂症核心症状特征（即阳性症状、妄想和幻觉、阴性症状和整体精神病症状）有效性的当前荟萃分析证据。数据来源：该meta-review于2023年7月28日在PROSPERO注册（CRD42023447442）。文章从2007年1月1日到2023年9月1日在5个电子数据库中检索。研究选择：针对针对精神病症状的元认知干预的元分析符合元综述的要求。数据提取和合成：适用时遵循PRISMA指南。数据提取由两位作者（AM， AS）独立完成。随机效应模型用于汇总meta分析中的数据。主要结局和测量：主要结局是干预后阳性症状、妄想和幻觉、阴性症状和总体精神病症状的水平/严重程度。结果：meta综述纳入8项meta分析和2项再分析。共有8项分析为分析提供了足够的数据。有显著证据支持MCT治疗阳性症状(85.71%；N = 35 g = 0.473 [0.295, 0.651], I2 = 74.64),妄想(60%;N = 24 g = 0.639 [0.389, 0.889], I2 = 80.01),幻觉(100%;N = 9, g = 0.265 [0.098, 0.432], I2 = 6.1),阴性症状(100%;N = 17 g = 0.233 [0.1, 0.366], I2 = 34.78)和总体症状(50%;N = 37, g = 0.392 [0.245, 0.538], I2 = 65.73)。根据metaumbrella.org指南（要求样本量为1000例），没有一项荟萃分析包括足够大的样本量，以满足“暗示”、“令人信服”或“高度令人信服”的证据标准。没有一项荟萃分析在方法质量上得分为“中等”或“高”。具有显著结果的荟萃分析是最近的和/或考虑了更多的初步研究。结论和相关性：有一致的证据表明MCT可以改善精神分裂症的阳性症状和妄想。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Translational Psychiatry PSYCHIATRY-

CiteScore

11.50

自引率

2.90%

发文量

484

审稿时长

23 weeks

期刊介绍： Psychiatry has suffered tremendously by the limited translational pipeline. Nobel laureate Julius Axelrod''s discovery in 1961 of monoamine reuptake by pre-synaptic neurons still forms the basis of contemporary antidepressant treatment. There is a grievous gap between the explosion of knowledge in neuroscience and conceptually novel treatments for our patients. Translational Psychiatry bridges this gap by fostering and highlighting the pathway from discovery to clinical applications, healthcare and global health. We view translation broadly as the full spectrum of work that marks the pathway from discovery to global health, inclusive. The steps of translation that are within the scope of Translational Psychiatry include (i) fundamental discovery, (ii) bench to bedside, (iii) bedside to clinical applications (clinical trials), (iv) translation to policy and health care guidelines, (v) assessment of health policy and usage, and (vi) global health. All areas of medical research, including — but not restricted to — molecular biology, genetics, pharmacology, imaging and epidemiology are welcome as they contribute to enhance the field of translational psychiatry.