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. 2020 Nov 27;10(4):253.
doi: 10.3390/jpm10040253.

Cognitive Insight in First-Episode Psychosis: Changes during Metacognitive Training

Irene Birulés  1   2 , Raquel López-Carrilero  1   3   4   5 , Daniel Cuadras  1   4 , Esther Pousa  6   7 , Maria Luisa Barrigón  8   9 , Ana Barajas  10   11 , Ester Lorente-Rovira  3   12 , Fermín González-Higueras  13 , Eva Grasa  3   6   14 , Isabel Ruiz-Delgado  15 , Jordi Cid  16 , Ana de Apraiz  1 , Roger Montserrat  1   2 , Trinidad Pélaez  1   3 , Steffen Moritz  17 , The Spanish Metacognition Study Group  18 , Susana Ochoa  1   3   5
Affiliations

Cognitive Insight in First-Episode Psychosis: Changes during Metacognitive Training

Irene Birulés et al. J Pers Med. .

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: Self-certainty decreased significantly (p = 0.03) over time and the effect of IQ was negative and significant (p = 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.

Keywords: cognitive insight; experiment; first-episode psychosis; metacognitive training; sessions.

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Conflict of interest statement

The authors declare no conflict of interest. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript; or in the decision to publish the results.

Figures

Figure 1
Figure 1
Research process flow-chart. MCT, metacognitive training.
Figure 2
Figure 2
Changes in self-certainty (SC) in every session and in the post-treatment.
Figure 3
Figure 3
Mean of self-reflectiveness (SR) in each session and in the post-treatment.
Figure 4
Figure 4
Mean of the Composite Index (CI) in each session and in the post-treatment.
See this image and copyright information in PMC

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