Sustained and "sleeper" effects of group metacognitive training for schizophrenia: a randomized clinical trial.

摘要: Importance Cognitive interventions increasingly complement psychopharmacological treatment to enhance symptomatic and functional outcome in schizophrenia. Metacognitive training (MCT) is targeted at cognitive biases involved the pathogenesis of delusions. Objective To examine long-term efficacy group MCT for schizophrenia order explore whether previously established effects were sustained. Design, Setting, Participants A 2-center, randomized, controlled, assessor-blind, parallel trial was conducted. total 150 inpatients or outpatients with DSM-IV diagnoses spectrum disorders enrolled. All patients prescribed antipsychotic medication. The second follow-up assessment took place 3 years later after intervention phase terminated. Interventions Group targeting vs neuropsychological (COGPACK). Patients received a maximum 16 sessions. Main Outcomes Measures primary measure delusion score derived from Positive Negative Syndrome Scale (PANSS). PANSS positive syndrome scores, Psychotic Symptom Rating Scales, jumping conclusions bias, self-esteem, quality life served as secondary measures. Results intention-to-treat analyses demonstrated that had significantly greater reductions core score, compared control (η 2 partial  = .037; P  = .05). Among outcomes, also  = .055;  = .02) Scales  = .109;  = .001). Significant differences 3-year found on measures self-esteem life, which did not distinguish groups earlier points. Attention improved relative group. completion rate 61.3% years. Conclusions Relevance sustained reduction delusions, over above Moreover, there some unanticipated (“sleeper”) both Effects well-being even absence an improvement bias. Trial Registration isrctn.org Identifier:ISRCTN95205723