Cognitive Insight in First-Episode Psychosis: Changes during Metacognitive Training
Irene Birulés, Raquel López‐Carrilero, Daniel Cuadras, Esther Pousa, María Luisa Barrigón, Ana Barajas, Ester Lorente‐Rovira, Fermín González‐Higueras, Eva Grasa, Isabel Ruiz‐Delgado, Jordi Cid, Ana de Apraiz, Roger Montserrat, Trinidad Peláez, Steffen Moritz, the Spanish Metacognition Study Group, Susana Ochoa
Abstract
BACKGROUND: Metacognitive training (MCT) has demonstrated its efficacy in psychosis. However, the effect of each MCT session has not been studied. The aim of the study was to assess changes in cognitive insight after MCT: (a) between baseline, post-treatment, and follow-up; (b) after each session of the MCT controlled for intellectual quotient (IQ) and educational level. METHOD: A total of 65 patients with first-episode psychosis were included in the MCT group from nine centers of Spain. Patients were assessed at baseline, post-treatment, and 6 months follow-up, as well as after each session of MCT with the Beck Cognitive Insight Scale (BCIS). The BCIS contains two subscales: self-reflectiveness and self-certainty, and the Composite Index. Statistical analysis was performed using linear mixed models with repeated measures at different time points. RESULTS: = 0.02). From session 4 to session 8, all sessions improved cognitive insight by significantly reducing self-certainty and the Composite Index. CONCLUSIONS: MCT intervention appears to have beneficial effects on cognitive insight by reducing self-certainty, especially after four sessions. Moreover, a minimum IQ is required to ensure benefits from MCT group intervention.