Andersson Erik, Aspvall Kristina, Schettini Greta, Kraepelien Martin, Särnholm Josefin, Wergeland Gro Janne, Öst Lars-Göran
Division of Psychology, Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden.
Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden.
Cogn Behav Ther. 2025 Mar;54(2):276-302. doi: 10.1080/16506073.2024.2434920. Epub 2024 Dec 18.
Metacognitive interventions have received increasing interest the last decade and there is a need to synthesize the evidence of these type of interventions. The current study is an updated systematic review and meta-analysis where we investigated the efficacy of metacognitive interventions for adults with psychiatric disorders. We included randomized controlled trials that investigated either metacognitive therapy (MCT; developed by Wells) or metacognitive training (MCTraining; developed by Moritz). Ovid MEDLINE, Embase OVID, and PsycINFO were searched for articles published until May 2024. The final analyses included 21 MCT- and 28 MCTraining studies (in total 3239 individuals). Results showed that MCT was more efficacious than both waiting-list control conditions ( = 1.84) as well as other forms of cognitive behavior therapies ( = 0.43). MCTraining was superior to treatment as usual ( = 0.45), other psychological treatments ( = 0.46) and placebo conditions ( = 0.15). Many of the included studies lacked data on blinding procedures, reporting of inter-rater reliability, treatment adherence, competence, treatment expectancy and pre-registration procedures. We conclude that both MCT and MCTraining are probably efficacious treatments but that future studies need to incorporate more quality aspects in their trial designs.
在过去十年中，元认知干预受到了越来越多的关注，因此有必要综合这类干预措施的证据。本研究是一项更新的系统评价和荟萃分析，我们调查了元认知干预对患有精神疾病的成年人的疗效。我们纳入了调查元认知疗法（MCT；由韦尔斯开发）或元认知训练（MCTraining；由莫里茨开发）的随机对照试验。检索了Ovid MEDLINE、Embase OVID和PsycINFO中截至2024年5月发表的文章。最终分析纳入了21项MCT研究和28项MCTraining研究（共3239名个体）。结果显示，MCT比等待名单对照条件（效应量=1.84）以及其他形式的认知行为疗法（效应量=0.43）更有效。MCTraining优于常规治疗（效应量=0.45）、其他心理治疗（效应量=0.46）和安慰剂条件（效应量=0.15）。许多纳入研究缺乏关于盲法程序、评分者间信度报告、治疗依从性、治疗能力、治疗预期和预注册程序的数据。我们得出结论，MCT和MCTraining可能都是有效的治疗方法，但未来的研究需要在试验设计中纳入更多质量方面的内容。
