SynthesisPsychological medicine2020
Can metacognitive interventions improve insight in schizophrenia spectrum disorders? A systematic review and meta-analysis.
Synthesis in Psychological medicine, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06127004 (Metacognitive Training for Negative Symptoms), which is not on this map. Cited by 32 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Metacognitive Training for Negative Symptoms (MCT Minus)
Who cites it
32 citing papers in PubMed, 2 syntheses or guidelines pooled it, 72 citations in OpenAlex.
- Metacognitive interventions for adolescents with mental disorders: a scoping review.Pediatric research · 2026Pooled it
- Immediate and Sustained Outcomes and Moderators Associated With Metacognitive Training for Psychosis: A Systematic Review and Meta-analysis.JAMA psychiatry · 2022Pooled it
- Impact of the Unified Protocol on Attenuated Psychotic Symptoms, Cognitive Biases and Cognitive Insight in Patients at Ultra High Risk (UHR) for Psychosis: Secondary Results of a Pilot Randomized Controlled Trial.Journal of clinical psychology · 2026Trial
- An empirical study of offline and online group metacognitive training in patients with schizophrenia.BMC psychiatry · 2025Trial
- Impaired insight in schizophrenia: impact on patient-reported and physician-reported outcome measures in a randomized controlled trial.BMC psychiatry · 2022Trial
- Sex-specific predictors of self-stigma reduction in psychosis resulting from metacognitive interventions: Results from a randomized clinical trial.Women's health (London, England)Trial
- Effects of the Japanese Version of Metacognitive Training on Self-Efficacy and Sense of Coherence in Community-Dwelling Patients with Schizophrenia: A Pilot Study.Community mental health journal · 2026Article
- Metacognition and Self-Disturbances in Schizophrenia: Implications for Psychological and Neurocognitive Therapy.Brain sciences · 2026Review
- Article
- Facial emotion recognition, insight and social functioning in first episode psychosis: a cross-sectional study from an observational cohort.BMC psychiatry · 2026Observational
- Changes in insight and outcome over the early course of first-episode psychosis. The OPTiMiSE trial.Schizophrenia research. Cognition · 2026Article
- Examining sex as a potential moderator of metacognitive training for psychosis efficacy on cognitive insight and jumping to conclusions bias: Evidence from a large-scale harmonized database.Schizophrenia research. Cognition · 2026Article
- Digital Assessment of Metacognition Across the Psychosis Continuum: Measures, Validity, and Clinical Integration-A Scoping Review.Medicina (Kaunas, Lithuania) · 2026Article
- Arabic validation of the VAGUS insight into psychosis scale among Lebanese patients with schizophrenia.Scientific reports · 2026Article
- PERMEPSY: a multicentre, randomized, double-blind proof-of-concept trial of personalized metacognitive training for adults with psychosis - a study protocol.Frontiers in psychiatry · 2026Article
- Turkish adaptation study of the Metacognition Assessment Scale-Abbreviated in psychotic disorders.Frontiers in psychology · 2026Article
- Clinical and cognitive insight in schizophrenia and their relationship with neurocognition and metacognition: a narrative review.Frontiers in psychiatry · 2026Review
- The RECAPACITA PROJECT: comparative study of the clinical, neuropsychological, and functional profile of people with severe mental disorder and partial and total capacity modification.Social psychiatry and psychiatric epidemiology · 2025Article
- Psychosocial Management of First-Episode Psychosis and Schizophrenia: Synopsis of the US Department of Veterans Affairs and US Department of Defense Clinical Practice Guidelines.Schizophrenia bulletin · 2025Article
- Data harmonization for the analysis of personalized treatment of psychosis with metacognitive training.Scientific reports · 2025Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
11 authors at 5 institutions in 3 countries.
Funding
Abstract
backgroundPatients with schizophrenia spectrum disorders (SSD) tend to lack insight, which is linked to poor outcomes. The effect size of previous treatments on insight changes in SSD has been small. Metacognitive interventions may improve insight in SSD, although this remains unproved.
methodsWe carried out a systematic review and meta-analysis of randomized controlled trials (RCTs) to examine the effects of metacognitive interventions designed for SSD, namely Metacognitive Training (MCT) and Metacognitive Reflection and Insight Therapy (MERIT), on changes in cognitive and clinical insight at post-treatment and at follow-up.
resultsTwelve RCTs, including 10 MCT RCTs (n = 717 participants) and two MERIT trials (n = 90), were selected, totalling N = 807 participants. Regarding cognitive insight six RCTs (n = 443) highlighted a medium effect of MCT on self-reflectiveness at post-treatment, d = 0.46, p < 0.01, and at follow-up, d = 0.30, p < 0.01. There was a small effect of MCT on self-certainty at post-treatment, d = -0.23, p = 0.03, but not at follow-up. MCT was superior to controls on an overall Composite Index of cognitive insight at post-treatment, d = 1.11, p < 0.01, and at follow-up, d = 0.86, p = 0.03, although we found evidence of heterogeneity. Of five MCT trials on clinical insight (n = 244 participants), which could not be meta-analysed, four of them favoured MCT compared v. control. The two MERIT trials reported conflicting results.
conclusionsMetacognitive interventions, particularly Metacognitive Training, appear to improve insight in patients with SSD, especially cognitive insight shortly after treatment. Further long-term RCTs are needed to establish whether these metacognitive interventions-related insight changes are sustained over a longer time period and result in better outcomes.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.