Claudia Requejo, Naomi Naides, Maria Lamarca, Marina Peniza-Soriano, Susana Ochoa
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引用次数: 0
Abstract
Purpose: Metacognitive interventions have emerged as promising therapeutic approaches for individuals experiencing a first episode of psychosis (FEP), given the relationship between metacognitive deficits, reduced cognitive insight, and symptom persistence. This systematic review synthesizes the available evidence on the effectiveness of metacognitive therapies in adults with FEP, focusing on their impact on cognitive insight, psychotic symptoms, and global functioning.
Methods: A systematic search was conducted in PubMed, PsycINFO, Web of Science, and Scopus following PRISMA guidelines, with prior registration in PROSPERO (CRD420261281443). Studies published between 2014 and 2025 were included if they applied metacognitive interventions to adult FEP samples and evaluated changes in psychotic symptomatology and/or cognitive insight using validated instruments. Methodological quality was assessed using the Mixed Methods Appraisal Tool.
Results: A total of 15 studies met the inclusion criteria. Overall, metacognitive interventions demonstrated consistent improvements in cognitive insight, notably increased self-reflectivity, and reduced overconfidence. Findings regarding psychotic symptom reduction were heterogeneous, although several studies reported significant improvements. Additional benefits were observed in neurocognitive domains, whereas results concerning social cognition were mixed. Interventions varied substantially in duration, format, and intensity, with most being delivered individually.
Conclusion: The available evidence suggests that metacognitive therapies constitute a promising treatment option for individuals with FEP, showing robust effects on cognitive insight and potential benefits for clinical and functional outcomes. Nonetheless, further high-quality research, particularly comparative trials and long-term follow-up studies, is needed to consolidate these findings and clarify their applicability across diverse clinical settings.
目的：考虑到元认知缺陷、认知洞察力降低和症状持续之间的关系，元认知干预已成为治疗首次精神病（FEP）个体的有希望的治疗方法。本系统综述综合了关于元认知疗法对FEP成人有效性的现有证据，重点关注其对认知洞察力、精神病症状和整体功能的影响。方法：系统检索PubMed、PsycINFO、Web of Science和Scopus，遵循PRISMA指南，事先在PROSPERO注册（CRD420261281443）。2014年至2025年间发表的研究如果对成人FEP样本应用元认知干预，并使用经过验证的工具评估精神病症状学和/或认知洞察力的变化，则纳入研究。使用混合方法评估工具评估方法学质量。结果：共有15项研究符合纳入标准。总体而言，元认知干预在认知洞察力方面表现出持续的改善，特别是增加了自我反思，减少了过度自信。关于精神病症状减轻的发现是不同的，尽管一些研究报告了显著的改善。在神经认知领域观察到额外的益处，而在社会认知方面的结果则喜忧参半。干预措施在持续时间、形式和强度上差异很大，大多数是单独实施的。结论：现有证据表明，元认知疗法对FEP患者来说是一种很有希望的治疗选择，对认知洞察力和临床和功能结果都有强有力的影响。然而，需要进一步的高质量研究，特别是比较试验和长期随访研究，来巩固这些发现，并澄清它们在不同临床环境中的适用性。
期刊介绍：
Die Zeitschrift ist das offizielle Organ der „Österreichischen Gesellschaft für Psychiatrie, Psychotherapie und Psychosomatik (ÖGPP)'', und wissenschaftliches Organ der Österreichischen Alzheimer Gesellschaft, der Österreichischen Gesellschaft für Kinder- und Jugendpsychiatrie, Psychosomatik und Psychotherapie, der Österreichischen Schizophreniegesellschaft, und der pro mente austria - Österreichischer Dachverband der Vereine und Gesellschaften für psychische und soziale Gesundheit.Sie veröffentlicht Übersichten zu relevanten Themen des Fachs, Originalarbeiten, Kasuistiken sowie Briefe an die Herausgeber. Zudem wird auch Buchbesprechungen sowie Neuigkeiten aus den Bereichen Personalia, Standes- und Berufspolitik sowie Kongressankündigungen Raum gewidmet.Thematisch ist das Fach Psychiatrie und die Methoden der Psychotherapie in allen ihren Facetten vertreten. Die Zeitschrift richtet sich somit an alle Berufsgruppen, die sich mit Ursachen, Erscheinungsformen und Behandlungsmöglichkeiten von psychischen Störungen beschäftigen. -----------------------------------------------------------------------------------------------------· The professional and educational journal of the Austrian Society of Psychiatry, Psychotherapy and Psychosomatics (Österreichische Gesellschaft für Psychiatrie, Psychotherapie und Psychosomatik; ÖGPP) and the Austrian Society of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy (Österreichische Gesellschaft für Kinder- und Jugendpsychiatrie, Psychosomatik und Psychotherapie; ÖGKJP)· Overviews of all relevant topics pertaining to the discipline· Intended for all occupational groups committed to the causes and manifestations of, as well as therapy options for psychic disorders· All manuscripts principally pass through a double-blind peer review process involving at least two independent expertsThe official journal of the Austrian Societies of Psychiatry, Psychotherapy and Psychosomatics (ÖGPP) and Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy (ÖGKJP)The journal publishes overviews of relevant issues in the field, original work, case reports and letters to the editors. In addition, space is devoted to book reviews, news from the areas of personnel matters and professional policies, and conference announcements.Thematically, the discipline of psychiatry and the methods of psychotherapy are represented in all their facets. The journal is thus aimed at all professional groups committed to the causes and manifestations of, as well as therapy options for psychic disorders
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