University of Évora, Évora, Portugal.
Comprehensive Health Research Centre (CHRC), Évora, Portugal.
J Adv Nurs. 2021 Feb;77(2):999-1012. doi: 10.1111/jan.14627. Epub 2020 Nov 22.
To evaluate the efficacy of metacognitive group training in reducing psychotic symptoms and improving cognitive insight and functions in people with schizophrenia.
Randomized controlled trial. It was carried out between July 2019 -February 2020.
Fifty-six patients with schizophrenia were enrolled and randomly assigned to either a control group (N = 29) or a metacognitive training group (N = 27). Blinded assessments were made at baseline, 1-week post-treatment and at follow-up 3 months after treatment. The primary outcome measure was psychotic symptoms based on the Psychotic Symptom Rating Scales (PSYRATS). Secondary outcomes were assessed by the Beck Cognitive Insight Scale (BCIS), the Personal and Social Performance (PSP) scale and the World Health Organization Disability Assessment Schedule (WHODAS).
Completion at follow-up was high (92.86%). The intention-to-treat analyses demonstrated that patients in the metacognitive training group had significantly greater improvements of the Psychotic Symptom Rating Scales delusion score and total score and the Personal and Social Performance Scale, after 3 months, compared with the control group. The effect size was medium to large. The intention-to-treat analyses also demonstrated that patients in the metacognitive training group had significantly greater reductions of the Psychotic Symptom Rating Scales hallucination score and Beck Cognitive Insight Scale self-certainty score post-treatment, compared with the control group. The effect size was medium to large.
The metacognitive training administered by psychiatric and mental health nurses was effective in ameliorating delusions and social functioning over time and it immediately reduced hallucinations post-treatment.
Metacognitive training for treating psychosis in patients with schizophrenia is efficacious and administration is clinically feasible in the Portuguese context.
ClinicalTrials.gov ID NCT03891186.
评估元认知团体训练对减少精神分裂症患者精神病症状和提高认知洞察力及功能的疗效。
随机对照试验。于 2019 年 7 月至 2020 年 2 月进行。
纳入 56 例精神分裂症患者，随机分为对照组（n=29）和元认知训练组（n=27）。在基线、治疗后 1 周和治疗后 3 个月进行盲法评估。主要结局指标为基于精神病症状评定量表（PSYRATS）的精神病症状。次要结局指标采用贝克认知洞察力量表（BCIS）、个人和社会表现量表（PSP）和世界卫生组织残疾评定量表（WHODAS）进行评估。
随访完成率高（92.86%）。意向性治疗分析表明，与对照组相比，元认知训练组患者在 3 个月后精神病症状评定量表妄想评分和总分以及个人和社会表现量表的改善更显著，效应量为中到大。意向性治疗分析还表明，与对照组相比，元认知训练组患者在治疗后精神病症状评定量表幻觉评分和贝克认知洞察力量表自我确信评分降低更显著，效应量为中到大。
精神科和心理健康护士实施的元认知训练在改善妄想和社会功能方面是有效的，且能即时减少幻觉。
元认知训练治疗精神分裂症患者的精神病症状是有效的，在葡萄牙语境下实施是具有临床可行性的。
ClinicalTrials.gov 注册号 NCT03891186。
