Immediate and Delayed Effects of Individualized Metacognitive Training for Psychosis (MCT+)

Deutsche Forschungsgemeinschaft (DFG) - Projektnummer 255362918

Enthusiasm for antipsychotic medications for schizophrenia has decreased following studies demonstrating only partial efficacy and high rates of non-compliance. Though medication remains the cornerstone of treatment, psychological interventions hold special promise as adjunctive treatments.Metacognitive Training (MCT) is based on literature demonstrating that specific cognitive biases are involved in the onset and maintenance of psychosis. MCT aims to "plant the seed of doubt" about these cognitive biases by first presenting delusion-neutral situations before addressing individual symptoms. The individualized version, MCT+, provides patients with the opportunity to focus on their most relevant cognitive biases and symptoms. While a growing literature demonstrates the efficacy of group MCT, there is only one underpowered pilot trial supporting the short-term efficacy of MCT+, and its long-term efficacy remains unclear. Within the framework of a randomized, controlled and observerblind trial, MCT+ will be compared to an active control (cognitive remediation). A total of 328 patients diagnosed with a schizophrenia spectrum disorder will be recruited across 4 sites and will complete 6- weeks of intervention. Participants' current symptoms, jumping to conclusions (JTC) bias, functional status and quality of life will be evaluated at baseline, after intervention and 6 months later. It is hypothesized that MCT+ will lead to a significant decline in positive symptoms, and improvements in JTC, quality of life and functional status relative to the control group.