Department of Psychiatry, School of Medicine, Faculty of Medicine, Universidad de Valparaíso, Valparaíso, Chile.
Psychotic Disorders Unit, Hospital Del Salvador de Valparaíso, Valparaíso, Chile.
Clin Psychol Psychother. 2024 Sep-Oct;31(5):e3065. doi: 10.1002/cpp.3065.
Metacognitive training (MCT) for psychosis is a group intervention that combines cognitive-behavioural therapy and psychoeducation. It has proven efficacy in reducing psychotic symptoms and correcting cognitive biases implicated in the development and maintenance of psychotic symptoms. However, other outcomes, such as patient satisfaction with the intervention, have not been well studied despite their importance for adherence and overall success. A systematic review of randomized clinical trials was conducted to assess satisfaction with MCT among adults with psychotic spectrum disorders.
The search was conducted in Ovid Embase, Ovid MEDLINE, PsycINFO and Cochrane Central Register of Controlled Trials (CENTRAL). PRISMA guidelines and the Cochrane Risk of Bias Tool were followed, and certainty of evidence was ascertained using the Grading of Recommendations Assessment, Development and Evaluation framework. The study is registered with PROSPERO (CRD42023418097).
Patient satisfaction was considered the primary outcome in 3 of the 10 studies reviewed. Four studies compared MCT with other psychosocial interventions (a newspaper discussion group, cognitive remediation and supportive therapy), two of which found significantly higher satisfaction with MCT. A high percentage of all patients found MCT comprehensible and considered it an important part of their treatment; they would recommend the training to others and found the group setting advantageous. Most participants expressed high subjective satisfaction or acceptance of MCT.
The authors found evidence that MCT may be associated with high levels of satisfaction in clinical trials whose main objective is to assess patient satisfaction, but more research is needed to consolidate the findings, especially for the extended version of MCT.
精神病认知训练（MCT）是一种团体干预措施，结合了认知行为疗法和心理教育。它已被证明在减少精神病症状和纠正与精神病症状的发展和维持有关的认知偏差方面有效。然而，其他结果，如患者对干预的满意度，尽管对依从性和整体成功很重要，但尚未得到很好的研究。对随机临床试验进行了系统评价，以评估有精神病谱障碍的成年人对 MCT 的满意度。
在 Ovid Embase、Ovid MEDLINE、PsycINFO 和 Cochrane 对照试验中心注册库（CENTRAL）中进行了检索。遵循 PRISMA 指南和 Cochrane 偏倚风险工具，使用推荐评估、制定与评价分级框架确定证据的确定性。该研究在 PROSPERO（CRD42023418097）上注册。
在审查的 10 项研究中，有 3 项研究将患者满意度视为主要结果。4 项研究将 MCT 与其他心理社会干预措施进行了比较（报纸讨论小组、认知矫正和支持性治疗），其中两项研究发现 MCT 的满意度明显更高。所有患者中有很大比例的人认为 MCT 易于理解，并认为 MCT 是他们治疗的重要组成部分；他们会向他人推荐培训，并认为小组设置有利。大多数参与者对 MCT 表示高度的主观满意或接受。
作者发现了证据表明，在主要目的是评估患者满意度的临床试验中，MCT 可能与高水平的满意度相关，但需要更多的研究来巩固这些发现，特别是对于 MCT 的扩展版本。
