Greater Manchester West Mental Health Foundation NHS Trust, and University of Manchester, UK.
University of Manchester, UK, and NTNU, Trondheim, Norway.
Behav Cogn Psychother. 2014 Mar;42(2):166-85. doi: 10.1017/S1352465812001026. Epub 2013 Jan 3.
More effective psychological treatments for psychosis are required. Case series data and pilot trials suggest metacognitive therapy (MCT) is a promising treatment for anxiety and depression. Other research has found negative metacognitive beliefs and thought-control strategies may be involved in the development and maintenance of hallucinations and delusions. The potential of MCT in treating psychosis has yet to be investigated.
Our aim was to find out whether a short number of MCT sessions would be associated with clinically significant and sustained improvements in delusions, hallucinations, anxiety, depression and subjective recovery in patients with treatment-resistant long-standing psychosis.
Three consecutively referred patients, each with a diagnosis of paranoid schizophrenia and continuing symptoms, completed a series of multiple baseline assessments. Each then received between 11 and 13 sessions of MCT and completed regular assessments of progress, during therapy, post-therapy and at 3-month follow-up.
Two out of 3 participants achieved clinically significant reductions across a range of symptom-based outcomes at end-of-therapy. Improvement was sustained at 3-month follow-up for one participant.
Our study demonstrates the feasibility of using MCT with people with medication-resistant psychosis. MCT was acceptable to the participants and associated with meaningful change. Some modifications may be required for this population, after which a controlled trial may be warranted.
需要更有效的心理治疗方法来治疗精神病。病例系列数据和试点试验表明，元认知疗法（MCT）是治疗焦虑和抑郁的一种很有前途的方法。其他研究发现，消极的元认知信念和思维控制策略可能与幻觉和妄想的发展和维持有关。MCT 在治疗精神病方面的潜力尚未得到研究。
我们的目的是了解少量的 MCT 疗程是否会与治疗抵抗性长期精神病患者的妄想、幻觉、焦虑、抑郁和主观康复方面的临床显著和持续改善相关。
连续转诊的 3 名患者，每个患者都有偏执型精神分裂症的诊断和持续症状，完成了一系列的多重基线评估。然后，每位患者接受了 11 至 13 次 MCT 治疗，并在治疗期间、治疗后和 3 个月随访期间定期评估进展情况。
3 名参与者中有 2 名在治疗结束时在一系列基于症状的结果上达到了临床显著的减少。一名参与者的改善在 3 个月随访时持续存在。
我们的研究表明，MCT 可用于治疗药物抵抗性精神病患者。MCT 被参与者接受，并与有意义的变化相关。可能需要针对该人群进行一些修改，然后可能需要进行对照试验。
