title: Metacognitive training for schizophrenia: a multicentre randomised controlled trial.
abstract: A psychotherapeutic approach for schizophrenia is now recommended as an adjuvant for psychopharmacology, since antipsychotic medications only have a partial impact especially as regards positive symptoms and insight. In addition, cognitive distortions and the lack of metacognitive skills might increase positive symptoms leading to poor social functioning. This underlines the need for specific approaches which target cognitive processes relevant for insight, and abilities in metacognition. Metacognitive training (MCT) is a structured group intervention, which enhances a patient's reflection on cognitive biases and improves problem-solving. The aim of our study was to assess MCTs' short term impact on insight, symptoms and quality of life. Fifty patients with schizophrenia or schizoaffective disorders and persistent positive symptoms (delusions or hallucinations) were enrolled in the study. After baseline assessment participants were randomised either to supportive therapy or MCT. Both groups used the same design (1h-session twice a week during 8weeks) although the basic knowledge given to participants was different between interventions. Participants were assessed at eight weeks based on the Scale to Assess Unawareness of Mental Disorder, Positive and Negative Syndrome Scale (PANSS), Psychotic Symptom Rating Scales, the Calgary Depression Scale for Schizophrenia and the Quality of Life Scale. Between-group differences were significant in favour of MCT on the PANSS positive scale. Between-group differences in post- and pre-test values showed a trend in favour of MCT for insight on hallucinations. Results of our study indicate that the MCT has an effect on reducing positive symptomatology, and a trend impact on insight and social functioning.
authors: Clinical Psychiatry Department, Dijon University Hospital, 21000 Dijon, France; EA 481 "Neurosciences Laboratory", Franche-Comté University, 1 place du Maréchal Leclerc, 25030 Besançon Cedex, France.
authors: Malick
authors: M
authors: Briki
authors: Clinical Psychiatry Department, Besançon University Hospital, 25030 Besançon Cedex, France; INSERM Technological Innovation Clinical Investigation Centre (INSERM CIC-IT 808), Besançon University Hospital, 25030 Besançon Cedex, France.
authors: Julie
authors: J
authors: Monnin
authors: EA 481 "Neurosciences Laboratory", Franche-Comté University, 1 place du Maréchal Leclerc, 25030 Besançon Cedex, France; Clinical Psychiatry Department, Besançon University Hospital, 25030 Besançon Cedex, France; INSERM Technological Innovation Clinical Investigation Centre (INSERM CIC-IT 808), Besançon University Hospital, 25030 Besançon Cedex, France.
authors: Emmanuel
authors: E
authors: Haffen
authors: EA 481 "Neurosciences Laboratory", Franche-Comté University, 1 place du Maréchal Leclerc, 25030 Besançon Cedex, France; Clinical Psychiatry Department, Besançon University Hospital, 25030 Besançon Cedex, France.
authors: Daniel
authors: D
authors: Sechter
authors: Community Psychiatry, Department of Psychiatry, University Hospital Center and University of Lausanne, Switzerland; La Source, School of Nursing Science, University of Applied Sciences of Western Switzerland, Lausanne, Switzerland.
authors: Jérôme
authors: J
authors: Favrod
authors: Clinical Psychiatry Department, Hospital of Novillars, 25220 Novillars, France.
authors: Christian
authors: C
authors: Netillard
authors: Clinical Psychiatry Department, Hospital of Novillars, 25220 Novillars, France.
authors: Elisabeth
authors: E
authors: Cheraitia
authors: Clinical Psychiatry Department, Hospital of Saint-Ylie, 39100 Dole, France.
authors: Karine
authors: K
authors: Marin
authors: Clinical Psychiatry Department, Hospital of Bavilliers, 90800 Bavilliers, France.
authors: Svetlana
authors: S
authors: Govyadovskaya
authors: Clinical Psychiatry Department, Besançon University Hospital, 25030 Besançon Cedex, France; INSERM Technological Innovation Clinical Investigation Centre (INSERM CIC-IT 808), Besançon University Hospital, 25030 Besançon Cedex, France.
authors: Grégory
authors: G
authors: Tio
authors: Clinical Psychiatry Department, Dijon University Hospital, 21000 Dijon, France.
authors: Bernard
authors: B
authors: Bonin
authors: Clinical Psychiatry Department, Dijon University Hospital, 21000 Dijon, France.
authors: Jean-Christophe
authors: JC
authors: Chauvet-Gelinier
authors: Clinical Psychiatry Department, Dijon University Hospital, 21000 Dijon, France.
authors: Stéphanie
authors: S
authors: Leclerc
authors: Clinical Psychiatry Department, Hospital of Rouffach, 68250 Rouffach, France.
authors: Yann
authors: Y
authors: Hodé
authors: Clinical Psychiatry Department, Strasbourg University Hospital, 67000 Strasbourg, France.
authors: Pierre
authors: P
authors: Vidailhet
authors: Clinical Psychiatry Department, Strasbourg University Hospital, 67000 Strasbourg, France.
authors: Fabrice
authors: F
authors: Berna
authors: Clinical Psychiatry Department, Strasbourg University Hospital, 67000 Strasbourg, France.
authors: Anna Zinetti
authors: AZ
authors: Bertschy
authors: EA 481 "Neurosciences Laboratory", Franche-Comté University, 1 place du Maréchal Leclerc, 25030 Besançon Cedex, France; Clinical Psychiatry Department, Besançon University Hospital, 25030 Besançon Cedex, France; INSERM Technological Innovation Clinical Investigation Centre (INSERM CIC-IT 808), Besançon University Hospital, 25030 Besançon Cedex, France.
authors: Pierre
authors: P
authors: Vandel
mesh_terms: D000328:Adult; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D003702:Delusions / Q000503:physiopathology / Q000628:therapy; D005260:Female; D005602:France; D006212:Hallucinations / Q000503:physiopathology / Q000628:therapy; D006801:Humans; D008297:Male; D011569:Psychiatric Status Rating Scales; D011618:Psychotic Disorders / Q000503:physiopathology / Q000628:therapy*; D011788:Quality of Life; D012559:Schizophrenia / Q000503:physiopathology / Q000628:therapy*; D012565:Schizophrenic Psychology; D012917:Social Adjustment; D013850:Thinking; D013997:Time Factors; D016896:Treatment Outcome
keywords: Cognitive biases; Insight; Metacognitive training; Randomised study; Schizophrenia