TY - JOUR
T1 - Investigating the efficacy of an individualized metacognitive therapy program (MCT+) for psychosis
T2 - study protocol of a multi-center randomized controlled trial
AU - Schneider, Brooke C.
AU - Brüne, Martin
AU - Bohn, Francesca
AU - Veckenstedt, Ruth
AU - Kolbeck, Katharina
AU - Krieger, Eva
AU - Becker, Anna
AU - Drommelschmidt, Kim Alisha
AU - Englisch, Susanne
AU - Eisenacher, Sarah
AU - Lee-Grimm, Sie-In
AU - Nagel, Matthias
AU - Zink, Mathias
AU - Moritz, Steffen
N1 - Copyright the Author(s) 2016. Version archived for private and non-commercial use with the permission of the author/s and according to publisher conditions. For further rights please contact the publisher.
PY - 2016/2/27
Y1 - 2016/2/27
N2 - Background: Psychological interventions are increasingly recommended as adjunctive treatments for psychosis, but their implementation in clinical practice is still insufficient. The individualized metacognitive therapy program (MCT+; www.uke.de/mct_plus) represents a low-threshold psychotherapeutic approach that synthesizes group metacognitive training (MCT) and cognitive behavioral therapy for psychosis, and addresses specific cognitive biases that are involved in the onset and maintenance of psychosis. It aims to "plant the seed of doubt" regarding rigid delusional convictions and to encourage patients to critically reflect, extend and change their approach to problem solving. Its second edition also puts more emphasis on affective symptoms. A recent meta-analysis of metacognitive interventions (MCT, MCT+) indicate small to moderate effects on positive symptoms and delusions, as well as high rates of acceptance. Nonetheless, no long-term studies of MCT+ involving large samples have been conducted. Methods: The goal of the present multi-center, observer-blind, parallel-group, randomized controlled trial is to compare the efficacy of MCT+ against an active control (cognitive remediation; MyBrainTraining©) in 328 patients with psychosis at three time points (baseline, immediately after intervention [6 weeks] and 6 months later). The primary outcome is change in psychosis symptoms over the 6-month follow-up period as assessed by the delusion subscale of the Psychotic Symptom Rating Scale. Secondary outcomes include jumping to conclusions, other positive symptoms of schizophrenia, depressive symptoms, self-esteem, quality of life, and cognitive insight. The study also seeks to elucidate mediating factors that promote versus impede symptom improvement across time. Discussion: This is the first multi-center randomized controlled trial to test the efficacy of individualized MCT+ in a large sample of patients with psychosis. The rationale for the trial, the design, and the strengths and limitations of the study are discussed.Trial Registration: The trial is registered through the German Clinical Trials Register (www.drks.de) as DRKS00008001. Registered 6 May 2015.
AB - Background: Psychological interventions are increasingly recommended as adjunctive treatments for psychosis, but their implementation in clinical practice is still insufficient. The individualized metacognitive therapy program (MCT+; www.uke.de/mct_plus) represents a low-threshold psychotherapeutic approach that synthesizes group metacognitive training (MCT) and cognitive behavioral therapy for psychosis, and addresses specific cognitive biases that are involved in the onset and maintenance of psychosis. It aims to "plant the seed of doubt" regarding rigid delusional convictions and to encourage patients to critically reflect, extend and change their approach to problem solving. Its second edition also puts more emphasis on affective symptoms. A recent meta-analysis of metacognitive interventions (MCT, MCT+) indicate small to moderate effects on positive symptoms and delusions, as well as high rates of acceptance. Nonetheless, no long-term studies of MCT+ involving large samples have been conducted. Methods: The goal of the present multi-center, observer-blind, parallel-group, randomized controlled trial is to compare the efficacy of MCT+ against an active control (cognitive remediation; MyBrainTraining©) in 328 patients with psychosis at three time points (baseline, immediately after intervention [6 weeks] and 6 months later). The primary outcome is change in psychosis symptoms over the 6-month follow-up period as assessed by the delusion subscale of the Psychotic Symptom Rating Scale. Secondary outcomes include jumping to conclusions, other positive symptoms of schizophrenia, depressive symptoms, self-esteem, quality of life, and cognitive insight. The study also seeks to elucidate mediating factors that promote versus impede symptom improvement across time. Discussion: This is the first multi-center randomized controlled trial to test the efficacy of individualized MCT+ in a large sample of patients with psychosis. The rationale for the trial, the design, and the strengths and limitations of the study are discussed.Trial Registration: The trial is registered through the German Clinical Trials Register (www.drks.de) as DRKS00008001. Registered 6 May 2015.
KW - Schizophrenia
KW - Metacognitive training
KW - Psychosis
KW - Cognitive biases
KW - Delusions
UR - http://www.scopus.com/inward/record.url?scp=85007462361&partnerID=8YFLogxK
U2 - 10.1186/s12888-016-0756-2
DO - 10.1186/s12888-016-0756-2
M3 - Article
C2 - 26921116
AN - SCOPUS:85007462361
SN - 1471-244X
VL - 16
JO - BMC Psychiatry
JF - BMC Psychiatry
M1 - 51
ER -