La Source, School of Nursing Sciences, University of Applied Sciences of Western Switzerland, avenue Vinet 30, 1004 Lausanne, Switzerland; Community Psychiatry Service, Department of psychiatry, University Hospital Center of Lausanne, site de Cery, 1008 Prilly, Switzerland.
La Source, School of Nursing Sciences, University of Applied Sciences of Western Switzerland, avenue Vinet 30, 1004 Lausanne, Switzerland; Community Psychiatry Service, Department of psychiatry, University Hospital Center of Lausanne, site de Cery, 1008 Prilly, Switzerland.
Eur Psychiatry. 2014 Jun;29(5):275-81. doi: 10.1016/j.eurpsy.2013.08.003. Epub 2013 Oct 28.
Persistent psychotic symptoms represent a major challenge for psychiatric care. Basic research has shown that psychotic symptoms are associated with cognitive biases. Metacognitive training (MCT) aims at helping patients to become aware of these biases and to improve problem-solving. Fifty-two participants fulfilling diagnostic criteria of schizophrenia or schizoaffective disorders and persistent delusions and stabilized antipsychotic medication were enrolled in this study. Following baseline assessment patients were randomized either to treatment as usual (TAU) conditions or TAU+MCT. The intervention consisted of eight weekly 1-hour sessions (maximum: 8 hours). Participants were assessed at 8 weeks and 6-months later by blind assessors. Participants were assessed with the Psychotic Symptoms Rating Scales (PSYRATS) and the positive subscale of the PANSS. Between-group differences in post- and pre-test values were significant at a medium effect size in favor of the MCT for the PSYRATS delusion scale and the positive scale of the PANSS both at post and follow-up. The results of this study indicate that MCT training has a surplus antipsychotic effect for patients suffering from schizophrenia-related disorders who demonstrate only a partial response to antipsychotic treatment and that the effect of the intervention persists for at least 6 months after the intervention.
持续性精神病症状是精神科护理的主要挑战。基础研究表明，精神病症状与认知偏差有关。元认知训练（MCT）旨在帮助患者意识到这些偏差，并提高解决问题的能力。本研究纳入了 52 名符合精神分裂症或分裂情感障碍诊断标准且存在持续性妄想并稳定使用抗精神病药物的患者。在基线评估后，患者被随机分配至常规治疗（TAU）组或 TAU+MCT 组。干预措施包括 8 周每周 1 小时的课程（最多 8 小时）。参与者由盲法评估者在 8 周和 6 个月后进行评估。参与者使用精神病症状评定量表（PSYRATS）和 PANSS 的阳性量表进行评估。在 MCT 组中，PSYRATS 妄想量表和 PANSS 的阳性量表在 post 和 follow-up 时的后测和前测值之间的组间差异具有中等效应量的优势。这项研究的结果表明，对于那些对抗精神病治疗仅有部分反应的、患有与精神分裂症相关障碍的患者，MCT 训练具有额外的抗精神病作用，并且干预的效果在干预结束后至少持续 6 个月。
