title: Metacognitive group training for schizophrenia spectrum patients with delusions: a randomized controlled trial.
abstract: BACKGROUND
  Metacognitive training (MCT) for patients with psychosis is a psychological group intervention that aims to educate patients about common cognitive biases underlying delusion formation and maintenance, and to highlight their negative consequences in daily functioning.
  
  
  METHODS
  In this randomized controlled trial, 154 schizophrenia spectrum patients with delusions were randomly assigned to either MCT + treatment as usual (TAU) or TAU alone. Both groups were assessed at baseline, and again after 8 and 24 weeks. The trial was completed fully by 111 patients. Efficacy was measured with the Psychotic Symptom Rating Scales (PSYRATS) Delusions Rating Scale (DRS), and with specific secondary measures referring to persecutory ideas and ideas of social reference (the Green Paranoid Thoughts Scale, GPTS), cognitive insight (the Beck Cognitive Insight Scale, BCIS), subjective experiences of cognitive biases (the Davos Assessment of Cognitive Biases Scale, DACOBS) and metacognitive beliefs (the 30-item Metacognitions Questionnaire, MCQ-30). Economic analysis focused on the balance between societal costs and health outcomes (quality-adjusted life years, QALYs).
  
  
  RESULTS
  Both conditions showed a decrease of delusions. MCT was not more efficacious in terms of reducing delusions, nor did it change subjective paranoid thinking and ideas of social reference, cognitive insight or subjective experience of cognitive biases and metacognitive beliefs. The results of the economic analysis were not in favour of MCT + TAU.
  
  
  CONCLUSIONS
  In the present study, MCT did not affect delusion scores and self-reported cognitive insight, or subjective experience of cognitive biases and metacognitive beliefs. MCT was not cost-effective.
authors: GGzE, De Woenselse Poort, Eindhoven,The Netherlands.
authors: B
authors: B
authors: van Oosterhout
authors: Department of Educational Neuroscience,VU University Amsterdam,The Netherlands.
authors: L
authors: L
authors: Krabbendam
authors: Retired clinical psychologist, Heiloo,The Netherlands.
authors: K
authors: K
authors: de Boer
authors: GGZ Noord-Holland-Noord, Heiloo,The Netherlands.
authors: J
authors: J
authors: Ferwerda
authors: Centre for Early Psychosis,Parnassia Psychiatric Institute,The Hague,The Netherlands.
authors: M
authors: M
authors: van der Helm
authors: Department of Epidemiology,University Medical Centre Groningen,The Netherlands.
authors: A D
authors: AD
authors: Stant
authors: Department of Psychosis Research,Parnassia Psychiatric Institute,The Hague,The Netherlands.
authors: M
authors: M
authors: van der Gaag
mesh_terms: D000328:Adult; D003702:Delusions / Q000209:etiology / Q000628:therapy*; D006801:Humans; D008875:Middle Aged; D011615:Psychotherapy, Group / Q000379:methods*; D011618:Psychotic Disorders / Q000150:complications / Q000628:therapy*; D012559:Schizophrenia / Q000150:complications / Q000628:therapy*; D016037:Single-Blind Method; D016896:Treatment Outcome