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Can metacognitive interventions improve insight in schizophrenia spectrum disorders? A systematic review and meta-analysis

dc.contributor.authorLópez-Morinigo, Javier D.
dc.contributor.authorAjnakina, Olesya
dc.contributor.authorSánchez-Escribano, Adela
dc.contributor.authorEscobedo Correa, Natalia
dc.contributor.authorGonzález Ruiz-Ruano, Verónica
dc.contributor.authorSánchez-Alonso, Sergio
dc.contributor.authorMata-Iturralde, Laura
dc.contributor.authorMuñoz-Lorenzo, Laura
dc.contributor.authorOchoa, Susana
dc.contributor.authorBaca-Garcia, Enrique
dc.contributor.authorDavid, Anthony S.
dc.date.accessioned2021-12-23T13:24:19Z
dc.date.available2021-12-23T13:24:19Z
dc.date.issued2020
dc.identifier.urihttp://repositorio.ucm.cl/handle/ucm/3655
dc.description.abstractBackground: Patients with schizophrenia spectrum disorders (SSD) tend to lack insight, which is linked to poor outcomes. The effect size of previous treatments on insight changes in SSD has been small. Metacognitive interventions may improve insight in SSD, although this remains unproved. Methods: We carried out a systematic review and meta-analysis of randomized controlled trials (RCTs) to examine the effects of metacognitive interventions designed for SSD, namely Metacognitive Training (MCT) and Metacognitive Reflection and Insight Therapy (MERIT), on changes in cognitive and clinical insight at post-treatment and at follow-up. Results: Twelve RCTs, including 10 MCT RCTs (n = 717 participants) and two MERIT trials (n = 90), were selected, totalling N = 807 participants. Regarding cognitive insight six RCTs (n = 443) highlighted a medium effect of MCT on self-reflectiveness at post-treatment, d = 0.46, p < 0.01, and at follow-up, d = 0.30, p < 0.01. There was a small effect of MCT on self-certainty at post-treatment, d = −0.23, p = 0.03, but not at follow-up. MCT was superior to controls on an overall Composite Index of cognitive insight at post-treatment, d = 1.11, p < 0.01, and at follow-up, d = 0.86, p = 0.03, although we found evidence of heterogeneity. Of five MCT trials on clinical insight (n = 244 participants), which could not be meta-analysed, four of them favoured MCT compared v. control. The two MERIT trials reported conflicting results. Conclusions: Metacognitive interventions, particularly Metacognitive Training, appear to improve insight in patients with SSD, especially cognitive insight shortly after treatment. Further long-term RCTs are needed to establish whether these metacognitive interventions-related insight changes are sustained over a longer time period and result in better outcomes.es_CL
dc.language.isoenes_CL
dc.rightsAtribución-NoComercial-SinDerivadas 3.0 Chile*
dc.rights.urihttp://creativecommons.org/licenses/by-nc-nd/3.0/cl/*
dc.sourcePsychological Medicine, 50(15), 2289 - 2301es_CL
dc.subjectInsightes_CL
dc.subjectOutcomeses_CL
dc.subjectMetacognitive interventionses_CL
dc.subjectSchizophrenia spectrum disorderses_CL
dc.titleCan metacognitive interventions improve insight in schizophrenia spectrum disorders? A systematic review and meta-analysises_CL
dc.typeArticlees_CL
dc.ucm.indexacionScopuses_CL
dc.ucm.indexacionIsies_CL
dc.ucm.uriwww.cambridge.org/core/journals/psychological-medicine/article/can-metacognitive-interventions-improve-insight-in-schizophrenia-spectrum-disorders-a-systematic-review-and-metaanalysis/983B48189DCAB882B1C2E41BA0AA9DC3es_CL
dc.ucm.doidoi.org/10.1017/S0033291720003384es_CL


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