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Ochoa S, López-Carrilero R, Barrigón ML, Pousa E, Barajas A, Lorente-Rovira E, González-Higueras F, Grasa E, Ruiz-Delgado I, Cid J, Birulés I, Esteban-Pinos I, Casañas R, Luengo A, Torres-Hernández P, Corripio I, Montes-Gámez M, Beltran M, De Apraiz A, Domínguez-Sánchez L, Sánchez E, Llacer B, Pélaez T, Bogas JL, Moritz S. Randomized control trial to assess the efficacy of metacognitive training compared with a psycho-educational group in people with a recent-onset psychosis. Psychol Med 2017; 47:1573-1584. [PMID: 28166848 DOI: 10.1017/s0033291716003421] [Citation(s) in RCA: 58] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
BACKGROUND Aims were to assess the efficacy of metacognitive training (MCT) in people with a recent onset of psychosis in terms of symptoms as a primary outcome and metacognitive variables as a secondary outcome. METHOD A multicenter, randomized, controlled clinical trial was performed. A total of 126 patients were randomized to an MCT or a psycho-educational intervention with cognitive-behavioral elements. The sample was composed of people with a recent onset of psychosis, recruited from nine public centers in Spain. The treatment consisted of eight weekly sessions for both groups. Patients were assessed at three time-points: baseline, post-treatment, and at 6 months follow-up. The evaluator was blinded to the condition of the patient. Symptoms were assessed with the PANSS and metacognition was assessed with a battery of questionnaires of cognitive biases and social cognition. RESULTS Both MCT and psycho-educational groups had improved symptoms post-treatment and at follow-up, with greater improvements in the MCT group. The MCT group was superior to the psycho-educational group on the Beck Cognitive Insight Scale (BCIS) total (p = 0.026) and self-certainty (p = 0.035) and dependence self-subscale of irrational beliefs, comparing baseline and post-treatment. Moreover, comparing baseline and follow-up, the MCT group was better than the psycho-educational group in self-reflectiveness on the BCIS (p = 0.047), total BCIS (p = 0.045), and intolerance to frustration (p = 0.014). Jumping to Conclusions (JTC) improved more in the MCT group than the psycho-educational group (p = 0.021). Regarding the comparison within each group, Theory of Mind (ToM), Personalizing Bias, and other subscales of irrational beliefs improved in the MCT group but not the psycho-educational group (p < 0.001-0.032). CONCLUSIONS MCT could be an effective psychological intervention for people with recent onset of psychosis in order to improve cognitive insight, JTC, and tolerance to frustration. It seems that MCT could be useful to improve symptoms, ToM, and personalizing bias.
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Affiliation(s)
- S Ochoa
- Parc Sanitari Sant Joan de Déu,Sant Boi de Llobregat, Barcelona,Spain
| | - R López-Carrilero
- Parc Sanitari Sant Joan de Déu,Sant Boi de Llobregat, Barcelona,Spain
| | - M L Barrigón
- Department of Psychiatry,IIS-Fundación Jiménez Díaz Hospital,Madrid,Spain
| | - E Pousa
- Investigación Biomédica en Red de Salud Mental, CIBERSAM,Madrid,Spain
| | - A Barajas
- Centre d'Higiene Mental Les Corts,Barcelona,Spain
| | - E Lorente-Rovira
- Investigación Biomédica en Red de Salud Mental, CIBERSAM,Madrid,Spain
| | | | - E Grasa
- Investigación Biomédica en Red de Salud Mental, CIBERSAM,Madrid,Spain
| | - I Ruiz-Delgado
- Unidad de Salud Mental Comunitaria Malaga Norte, UGC Salud Mental Carlos Haya,Servicio Andaluz de Salud Málaga,Spain
| | - J Cid
- Mental Health & Addiction Research Group, IdiBGi. Institut d'Assistencia Sanitària,Girona,Spain
| | - I Birulés
- Parc Sanitari Sant Joan de Déu,Sant Boi de Llobregat, Barcelona,Spain
| | - I Esteban-Pinos
- Psychiatry Service, Area de Gestión Sanitaria Sur Granada,Motril,Granada,Spain
| | - R Casañas
- Centre d'Higiene Mental Les Corts,Barcelona,Spain
| | - A Luengo
- Investigación Biomédica en Red de Salud Mental, CIBERSAM,Madrid,Spain
| | | | - I Corripio
- Investigación Biomédica en Red de Salud Mental, CIBERSAM,Madrid,Spain
| | - M Montes-Gámez
- Unidad de Salud Mental Comunitaria Malaga Norte, UGC Salud Mental Carlos Haya,Servicio Andaluz de Salud Málaga,Spain
| | - M Beltran
- Mental Health & Addiction Research Group, IdiBGi. Institut d'Assistencia Sanitària,Girona,Spain
| | - A De Apraiz
- Parc Sanitari Sant Joan de Déu,Sant Boi de Llobregat, Barcelona,Spain
| | - L Domínguez-Sánchez
- Psychiatry Service, Area de Gestión Sanitaria Norte de Málaga,Antequera,Málaga,Spain
| | - E Sánchez
- Centre d'Higiene Mental Les Corts,Barcelona,Spain
| | - B Llacer
- Investigación Biomédica en Red de Salud Mental, CIBERSAM,Madrid,Spain
| | - T Pélaez
- Parc Sanitari Sant Joan de Déu,Sant Boi de Llobregat, Barcelona,Spain
| | - J L Bogas
- Parc Sanitari Sant Joan de Déu,Sant Boi de Llobregat, Barcelona,Spain
| | - S Moritz
- Department of Psychiatry and Psychotherapy,University Medical Center Hamburg,Hamburg,Germany
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Gaudelus B, Virgile J, Peyroux E, Leleu A, Baudouin JY, Franck N. [Measuring impairment of facial affects recognition in schizophrenia. Preliminary study of the facial emotions recognition task (TREF)]. Encephale 2014; 41:251-9. [PMID: 25240938 DOI: 10.1016/j.encep.2014.08.013] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2013] [Accepted: 04/01/2014] [Indexed: 11/18/2022]
Abstract
INTRODUCTION The impairment of social cognition, including facial affects recognition, is a well-established trait in schizophrenia, and specific cognitive remediation programs focusing on facial affects recognition have been developed by different teams worldwide. However, even though social cognitive impairments have been confirmed, previous studies have also shown heterogeneity of the results between different subjects. Therefore, assessment of personal abilities should be measured individually before proposing such programs. PURPOSE Most research teams apply tasks based on facial affects recognition by Ekman et al. or Gur et al. However, these tasks are not easily applicable in a clinical exercise. Here, we present the Facial Emotions Recognition Test (TREF), which is designed to identify facial affects recognition impairments in a clinical practice. The test is composed of 54 photos and evaluates abilities in the recognition of six universal emotions (joy, anger, sadness, fear, disgust and contempt). Each of these emotions is represented with colored photos of 4 different models (two men and two women) at nine intensity levels from 20 to 100%. Each photo is presented during 10 seconds; no time limit for responding is applied. METHOD The present study compared the scores of the TREF test in a sample of healthy controls (64 subjects) and people with stabilized schizophrenia (45 subjects) according to the DSM IV-TR criteria. We analysed global scores for all emotions, as well as sub scores for each emotion between these two groups, taking into account gender differences. Our results were coherent with previous findings. Applying TREF, we confirmed an impairment in facial affects recognition in schizophrenia by showing significant differences between the two groups in their global results (76.45% for healthy controls versus 61.28% for people with schizophrenia), as well as in sub scores for each emotion except for joy. Scores for women were significantly higher than for men in the population without psychiatric diagnosis. The study also allowed the identification of cut-off scores; results below 2 standard deviations of the healthy control average (61.57%) pointed to a facial affect recognition deficit. CONCLUSION The TREF appears to be a useful tool to identify facial affects recognition impairment in schizophrenia. Neuropsychologists, who have tried this task, have positive feedback. The TREF is easy to use (duration of about 15 minutes), easy to apply in subjects with attentional difficulties, and tests facial affects recognition at ecological intensity levels. These results have to be confirmed in the future with larger sample sizes, and in comparison with other tasks, evaluating the facial affects recognition processes.
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Affiliation(s)
- B Gaudelus
- Service universitaire de réhabilitation, centre hospitalier le Vinatier, 98, rue Boileau, 69006 Lyon, France.
| | - J Virgile
- Service universitaire de réhabilitation, centre hospitalier le Vinatier, 98, rue Boileau, 69006 Lyon, France
| | - E Peyroux
- Service universitaire de réhabilitation, centre hospitalier le Vinatier, 98, rue Boileau, 69006 Lyon, France; Centre de neuroscience cognitive, UMR 5229 CNRS, 67, boulevard Pinel, 69675 Bron cedex, France
| | - A Leleu
- Centre des sciences du Goût et de l'alimentation, UMR 6265 CNRS, UMR 1324 INRA, université de Bourgogne, bâtiment centre des sciences du goût, 9E, boulevard Jeanne-d'Arc, 21000 Dijon, France
| | - J-Y Baudouin
- Centre des sciences du Goût et de l'alimentation, UMR 6265 CNRS, UMR 1324 INRA, université de Bourgogne, bâtiment centre des sciences du goût, 9E, boulevard Jeanne-d'Arc, 21000 Dijon, France
| | - N Franck
- Service universitaire de réhabilitation, centre hospitalier le Vinatier, 98, rue Boileau, 69006 Lyon, France; Centre de neuroscience cognitive, UMR 5229 CNRS, 67, boulevard Pinel, 69675 Bron cedex, France
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