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Megacognitive training improved symptoms of schizophrenia

Compared with neuropsychological training, megacognitive training significantly improved symptoms of schizophrenia, according to recent study findings published in JAMA Psychiatry.

Steffen Moritz, PhD, of the department of psychiatry and psychotherapy at the University Medical Center Hamburg-Eppendorf in Germany, and colleagues evaluated 150 adults aged 18 to 65 years with a DSM-IV diagnosis of schizophrenia to determine the effect of group metacognitive training (MCT) vs. neuropsychological training (COGPACK) on symptoms and functional outcome. Participants were randomly assigned to either eight sessions of MCT (n=76) or COGPACK (control group; n=74). Antipsychotic medications were prescribed to all participants, and follow-up was conducted 3 years following the end of the intervention.

Intention-to-treat and per-protocol analyses were conducted; intention-to-treat considered baseline data and per-protocol considered endpoint data. At follow-up, a significant difference was found for the Positive and Negative Syndrome Scale (PANSS) core delusion score in the intention-to-treat (P=.05) but not the per-protocol analysis (P=.12).

Participants in the MCT group had significantly lower Psychosis Rating Scales delusion subscale scores compared with the control group at follow-up. Similarly, the intention-to-treat analysis was significantly different between the two groups for the total PANSS score; this was not true for the per-protocol analysis.

At follow-up, the MCT group showed greater improvement for self-esteem vs. the control group. However, the control group had greater improvement for selective attention.

“To summarize, MCT, a low-threshold and low-intensity group training (up to 16 sessions), led to substantial symptom improvements (relative to a control intervention) that were sustained 3 years after training and also accompanied by a delayed improvement in quality of life and self-esteem,” the researchers wrote. “The destigmatizing/normalizing approach of the program, which highlights similarities to normal behavior while not downplaying psychotic symptoms, may have contributed to the improvement by reducing feelings of stress, guilt, and stigmatization; however, dismantling studies are needed to verify this hypothesis.”

Disclosure: See the full study for a complete list of the researchers’ relevant financial disclosures.