Patients with schizophrenia who take antipsychotic medications often find that many of their symptoms remain troubling, so researchers are on the hunt for psychosocial therapy strategies that can be used in addition to medications. A new study published August 6th in JAMA Psychiatry reports that a short course of a relatively new kind of cognitive therapy, termed metacognitive training, is able to reduce delusions in patients with schizophrenia, and over the longer term (at the three-year mark) also improves self-esteem and quality of life.

Metacognitive training targets psychotic symptoms by improving the thought patterns that can lead to delusions and other types of disordered thinking. The goal of metacognitive therapy is to reduce cognitive biases―errors in thinking such as jumping too quickly to conclusions or maintaining beliefs in the face of contradicting evidence. This is accomplished first by making the patient aware of these distorted thought patterns—thinking about their own thinking, so to speak—and then by helping them rework these patterns through guided exercises that often employ humor.

2014 NARSAD Independent Investigator Grantee (and two-time NARSAD Young Investigator Grantee) Steffen Moritz, Ph.D., of the University Medical Center Hamburg-Eppendorf in Hamburg, Germany, who developed metacognitive training together with two-time NARSAD Young Investigator Grantee Todd Woodward, Ph.D., of the University of British Columbia in Vancouver, Canada, spearheaded the latest trial. 2012 NARSAD Young Investigator Grantees Christina Andreou, M.D., Ph.D., also of University Medical Center Hamburg-Eppendorf, and Mahesh Menon, Ph.D., of the University of British Columbia, were also part of the research team.

For the trial, the researchers randomly assigned 150 patients with schizophrenia who take antipsychotic medication to receive eight to 16 sessions of either group metacognitive training or a control type of training that teaches patients to improve various components of cognition such as attention and memory. Patients were assessed after four weeks, six months, and three years. At all three time points the patients in the metacognitive training group displayed fewer disruptive delusions than those in the control group. Interestingly, patient assessments of quality of life and self-esteem were also significantly improved in the metacognitive group after three years, though they had not been higher at the earlier time points.

Read the abstract of this research paper.

Read more about this research on the Schizophrenia Research Forum.