Immediate and Delayed Effects of Individualized Metacognitive Training for Psychosis (MCT+)

对精神分裂症的抗精神病药物的热情已经下降，因为研究表明只有部分疗效和高不依从率。虽然药物仍然是治疗的基石，但心理干预作为辅助治疗具有特殊的前景。元认知训练（MCT）是基于文献表明，特定的认知偏差参与精神病的发病和维持。MCT的目的是在解决个体症状之前，先呈现幻觉中性的情况，从而对这些认知偏见“播下怀疑的种子”。个体化版本MCT+为患者提供了关注他们最相关的认知偏差和症状的机会。虽然越来越多的文献证明了MCT组的疗效，但只有一项动力不足的试点试验支持MCT+的短期疗效，其长期疗效尚不清楚。在一项随机、对照和观察者盲试验的框架内，MCT+将与主动对照（认知修复）进行比较。共有328名诊断为精神分裂症谱系障碍的患者将在4个地点被招募，并将完成为期6周的干预。将在基线、干预后和6个月后评估参与者的当前症状、跳向结论（JTC）偏差、功能状态和生活质量。假设MCT+将导致阳性症状显著下降，相对于对照组，JTC、生活质量和功能状态均有改善。

Enthusiasm for antipsychotic medications for schizophrenia has decreased following studies demonstrating only partial efficacy and high rates of non-compliance. Though medication remains the cornerstone of treatment, psychological interventions hold special promise as adjunctive treatments.Metacognitive Training (MCT) is based on literature demonstrating that specific cognitive biases are involved in the onset and maintenance of psychosis. MCT aims to "plant the seed of doubt" about these cognitive biases by first presenting delusion-neutral situations before addressing individual symptoms. The individualized version, MCT+, provides patients with the opportunity to focus on their most relevant cognitive biases and symptoms. While a growing literature demonstrates the efficacy of group MCT, there is only one underpowered pilot trial supporting the short-term efficacy of MCT+, and its long-term efficacy remains unclear. Within the framework of a randomized, controlled and observerblind trial, MCT+ will be compared to an active control (cognitive remediation). A total of 328 patients diagnosed with a schizophrenia spectrum disorder will be recruited across 4 sites and will complete 6- weeks of intervention. Participants' current symptoms, jumping to conclusions (JTC) bias, functional status and quality of life will be evaluated at baseline, after intervention and 6 months later. It is hypothesized that MCT+ will lead to a significant decline in positive symptoms, and improvements in JTC, quality of life and functional status relative to the control group.