A Study on the Effectiveness of Metacognitive Training in Treating Negative Symptoms of Different Subtypes of...

This study aims to investigate the efficacy of metacognitive training (MCT) as an adjunctive treatment strategy for schizophrenia, particularly its impact on negative symptoms and potential mechanisms.

This study included a total of 73 inpatients with schizophrenia. 36 patients were in the MCT group and 37 patients were in the control group. Both groups of patients were receiving a single second-generation antipsychotic drug treatment. The MCT group underwent a 4-week MCT program consisting of 8 modules, while the control group received non-cognitive psychological support for the same duration and frequency. The Positive and Negative Syndrome Scale (PANSS) five-factor model and negative symptom two-factor model were used to assess psychiatric symptoms, and the Snyder's Self-Monitoring Scale (SSMS) and the Personal and Social Performance Scale (PSP) were used as functional evaluation indicators.

After treatment, compared to the control group, the MCT group had significantly lower scores in the PANSS total score (p<0.001), negative factor (p=0.002), and hostility factor (p=0.046). Further, the PSP score (p<0.001) and SSMS score (p=0.042) were significantly improved. In the two-factor analysis of negative symptoms, the MCT group showed significant improvements in both diminished expression (DE) symptoms (p<0.001) and social amotivation (SA) symptoms (p=0.010) after treatment. Multivariate linear regression analysis revealed that changes in the reduction rates of P2 (Conceptual disorganization), N7 (stereotyped thinking), and SA scores had a significant impact on the reduction in DE scores; changes in the reduction rates of P6 (Suspiciousness/persecution) and DE scores had a significant impact on the reduction rate of SA scores (p<0.05).

MCT can improve the clinical symptoms and functions of patients with schizophrenia, especially in the DE factor characterized by conceptual disorganization and stereotyped thinking, and the SA factor prominent in suspiciousness/persecution symptom. This provides insights for the precise treatment of negative symptoms.