Individualized metacognitive therapy for delusions: A randomized controlled rater-blind study.

Autor: Andreou C; Center for Gender Research and Early Detection, University Psychiatric Clinics Basel, Switzerland; Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Germany. Electronic address: Christina.Andreou@upkbs.ch., Wittekind CE; Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Germany., Fieker M; Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Germany., Heitz U; Center for Gender Research and Early Detection, University Psychiatric Clinics Basel, Switzerland., Veckenstedt R; Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Germany., Bohn F; Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Germany., Moritz S; Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Germany.
Jazyk: angličtina
Zdroj: Journal of behavior therapy and experimental psychiatry [J Behav Ther Exp Psychiatry] 2017 Sep; Vol. 56, pp. 144-151. Date of Electronic Publication: 2016 Nov 29.
DOI: 10.1016/j.jbtep.2016.11.013
Abstrakt: Background: Theory-driven interventions targeting specific factors that contribute to delusions are receiving increased interest. The present study aimed to assess the efficacy of individualized metacognitive therapy (MCT+), a short manualized intervention that addresses delusion-associated cognitive biases.
Methods: 92 patients with current or past delusions were randomized to receive 12 twice-weekly sessions of either MCT+ or a control intervention within a randomized controlled rater-blind design. Psychopathology and cognitive biases were assessed at baseline, 6 weeks and 6 months. ANCOVAs adjusted for baseline scores were used to assess differences between groups regarding outcome variables. Both per-protocol and intention-to-treat analyses were conducted.
Results: At 6 weeks, there was a significant difference in favor of MCT+ regarding decrease in delusion severity and improvement of self-reflectiveness (medium effect size), and a trend-wise difference regarding probability thresholds to decision. These effects increased, when only patients attending a minimum of 4 therapy sessions were considered. Control group patients subsequently showed further improvement while patients in the MCT+ group remained stable, such that there were no differences between groups at the 6-month follow-up.
Limitations: Lower attendance rates in the control group possibly leading to unequal therapeutic effort; lower baseline delusion severity in the MCT+ group.
Conclusions: The result pattern suggests that MCT+ led to earlier improvement in delusions and cognitive biases compared to the control intervention. The absence of a long-term effect might reflect floor effects in the MCT+ group, but may also indicate the need for further measures to promote sustainability of MCT+ effects.
(Copyright © 2016 Elsevier Ltd. All rights reserved.)
Databáze: MEDLINE
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