- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT04429412
Effectiveness of the Individualized Metacognitive Training (EMC+) in People With Psychosis of Brief Evolution
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
This is a randomized clinical trial in which some patients receive the EMC+ and others treatment as usual.The evaluator will be blind to the group to which the patients belong. The sample for the overall project will be a total of 70 people with a diagnosis of psychotic spectrum, less than 5 years of experience and with a score => 3 positive PANSS (last month) and treated in one of the participating institutions. The evaluation was performed at baseline, at post-treatment and at 6 months follow up. Symptoms, metacognition, psychosocial and neuropsychological functioning were assessed.
The EMC consists of 10 therapeutic units with weekly sessions of 45-60 minutes. The material available for the Individualized Metacognitive Training (EMC) program is made up of power-point presentations.
Study Type
Enrollment (Actual)
Phase
- Not Applicable
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Diagnosis of : schizophrenia, schizoaffective disorder, brief psychotic disorder, delusional disorder, schizophreniform disorder, psychotic disorder not otherwise specified.
- Less than 5 years of evolution.
- Score at or above 4 on the PANSS during the last year (delusions, grandiosity, suspiciousness).
Exclusion Criteria:
- Traumatic brain injury, dementia, or intellectual disability (premorbid IQ ≤70).
- Substance dependence.
- Score at or above 5 on the PANSS ( Hostility and Uncooperativeness); score at or above 6 on the PANSS (suspiciousness).
Study Plan
How is the study designed?
Design Details
- Primary Purpose: TREATMENT
- Allocation: RANDOMIZED
- Interventional Model: PARALLEL
- Masking: SINGLE
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
EXPERIMENTAL: Metacognitive Training (MCT+)
MCT+ combines the process-oriented approach of metacognitive group training with elements of individual cognitive-behavioral therapy. The metacognitive training program is comprised of 10 modules targeting common cognitive errors in schizophrenia. (Moritz et al, 2013). The modules are: 1:Therapeutic alliance, 2: Introducyion to MCT+, 3:Disease model, 4: Attributional style, 5: Decision making, 6: Changing beliefs, 7: Empathizing, 8: Memory, 9: Depression and self-steem, 10: Relapse prevention. The treatment consist of 10 weekly sessions of 45-60 minutes. |
Metacognitive training
|
NO_INTERVENTION: TAU
Treatment as usual.
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
PANSS. Positive and Negative Syndrome Scale. (Kay et al., 1987; Peralta and Cuesta, 1994)
Time Frame: baseline.
|
The Positive and Negative Syndrome Scale (PANSS).
This scale measures 30 symptoms on a scale of 1-7, with higher scores indicating greater psychopathology.
The PANSS contains three sub-scales: positive, negative and general symptoms.
Range: 7-112.
Higher values represent a worse outcome.
|
baseline.
|
PANSS. Positive and Negative Syndrome Scale. (Kay et al., 1987; Peralta and Cuesta, 1994)
Time Frame: immediately after the intervention
|
The Positive and Negative Syndrome Scale (PANSS).
This scale measures 30 symptoms on a scale of 1-7, with higher scores indicating greater psychopathology.
The PANSS contains three sub-scales: positive, negative and general symptoms.Range: 7-112.
Higher values represent a worse outcome.
|
immediately after the intervention
|
PANSS. Positive and Negative Syndrome Scale. (Kay et al., 1987; Peralta and Cuesta, 1994)
Time Frame: 6 months follow-up
|
The Positive and Negative Syndrome Scale (PANSS).
This scale measures 30 symptoms on a scale of 1-7, with higher scores indicating greater psychopathology.
The PANSS contains three sub-scales: positive, negative and general symptoms.Range: 7-112.
Higher values represent a worse outcome.
|
6 months follow-up
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Jumping to conclusions. (Brett-Jones et al. 1987).
Time Frame: baseline
|
Three different computer tasks were used in the study.
In Task 1, jars contained balls of two different colors; in one of them the proportion was 85 black versus 15 orange balls and in the other the ratio was reversed.
Task 2 was the same as Task 1 but with a proportion of 60:40 in each jar.
Finally, Task 3 was similar to Task 2 but instead of balls, the jars contained positive or negative comments with a proportion of 60:40.
The patients had to decide which to jar belonged the extracted balls or comments.
At all times the participants had information about the balls previously extracted, in order to control the effect of memory.
The subjects could remove as many balls as needed to make their final decision (Garety et al., 2005).
JTC was considered as taking a decision after extracting 1 or 2 balls.Dichotomous: yes/no.
A "yes" represents a worse outcome
|
baseline
|
Jumping to conclusions. (Brett-Jones et al. 1987).
Time Frame: immediately after the intervention
|
Three different computer tasks were used in the study.
In Task 1, jars contained balls of two different colors; in one of them the proportion was 85 black versus 15 orange balls and in the other the ratio was reversed.
Task 2 was the same as Task 1 but with a proportion of 60:40 in each jar.
Finally, Task 3 was similar to Task 2 but instead of balls, the jars contained positive or negative comments with a proportion of 60:40.
The patients had to decide which to jar belonged the extracted balls or comments.
At all times the participants had information about the balls previously extracted, in order to control the effect of memory.
The subjects could remove as many balls as needed to make their final decision (Garety et al., 2005).
JTC was considered as taking a decision after extracting 1 or 2 balls.Dichotomous: yes/no.
A "yes" represents a worse outcome
|
immediately after the intervention
|
Jumping to conclusions. (Brett-Jones et al. 1987).
Time Frame: 6 months follow-up
|
Three different computer tasks were used in the study.
In Task 1, jars contained balls of two different colors; in one of them the proportion was 85 black versus 15 orange balls and in the other the ratio was reversed.
Task 2 was the same as Task 1 but with a proportion of 60:40 in each jar.
Finally, Task 3 was similar to Task 2 but instead of balls, the jars contained positive or negative comments with a proportion of 60:40.
The patients had to decide which to jar belonged the extracted balls or comments.
At all times the participants had information about the balls previously extracted, in order to control the effect of memory.
The subjects could remove as many balls as needed to make their final decision (Garety et al., 2005).
JTC was considered as taking a decision after extracting 1 or 2 balls.Dichotomous: yes/no.
A "yes" represents a worse outcome
|
6 months follow-up
|
BCIS. Beck Cognitive and Insight Scale. (Beck et al., 2004; Gutierrez-Zotes et al., 2012)
Time Frame: baseline
|
The Beck Cognitive Insight Scale.
this scale is a self-registering measure of 15 items .which
evaluates how the patients assess their own judgement.
It has two dimensions; self-reflection (R) (9 items), and self-certainty (C) (6 items).
A compound index of cognitive insight is obtained as the subtraction of self-certainty from self-reflection (R-C).Range: 0-45.
Higher values represent a better outcome
|
baseline
|
BCIS. Beck Cognitive and Insight Scale. (Beck et al., 2004; Gutierrez-Zotes et al., 2012)
Time Frame: immediately after the intervention
|
The Beck Cognitive Insight Scale.
this scale is a self-registering measure of 15 items .which
evaluates how the patients assess their own judgement.
It has two dimensions; self-reflection (R) (9 items), and self-certainty (C) (6 items).
A compound index of cognitive insight is obtained as the subtraction of self-certainty from self-reflection (R-C).Range: 0-45.
Higher values represent a better outcome
|
immediately after the intervention
|
BCIS. Beck Cognitive and Insight Scale. (Beck et al., 2004; Gutierrez-Zotes et al., 2012)
Time Frame: 6 months follow-up
|
The Beck Cognitive Insight Scale.
this scale is a self-registering measure of 15 items .which
evaluates how the patients assess their own judgement.
It has two dimensions; self-reflection (R) (9 items), and self-certainty (C) (6 items).
A compound index of cognitive insight is obtained as the subtraction of self-certainty from self-reflection (R-C).Range: 0-45.
Higher values represent a better outcome
|
6 months follow-up
|
IPSAQ. Internal, Personal and Situational Attribution Questionnaire. (Kinderman & Bentall, 1996)
Time Frame: baseline
|
The scale assess the attributional style in 32 situations.
Personalizing Bias (PB) indicates the proportion of external attributions for negative events which are personal as opposed to situational.
A PB score of greater than 0.5 therefore represents a greater tendency to use personal rather than situational external attributions for negative events.
|
baseline
|
IPSAQ. Internal, Personal and Situational Attribution Questionnaire. (Kinderman & Bentall, 1996)
Time Frame: immediately after the intervention
|
The scale assess the attributional style in 32 situations.
Personalizing Bias (PB) indicates the proportion of external attributions for negative events which are personal as opposed to situational.
A PB score of greater than 0.5 therefore represents a greater tendency to use personal rather than situational external attributions for negative events.
|
immediately after the intervention
|
IPSAQ. Internal, Personal and Situational Attribution Questionnaire. (Kinderman & Bentall, 1996)
Time Frame: 6 months follow-up
|
The scale assess the attributional style in 32 situations.
Personalizing Bias (PB) indicates the proportion of external attributions for negative events which are personal as opposed to situational.
A PB score of greater than 0.5 therefore represents a greater tendency to use personal rather than situational external attributions for negative events.
|
6 months follow-up
|
The Hinting Task. (Corcoran et al. 1995; Gil et al. 2012)
Time Frame: baseline
|
The Scale assess Theory of Mind.Possible range: 0-12.
Higher values represent a better outcome
|
baseline
|
The Hinting Task. (Corcoran et al. 1995; Gil et al. 2012)
Time Frame: immediately after the intervention
|
The Scale assess Theory of Mind.
Possible range: 0-12.
Higher values represent a better outcome
|
immediately after the intervention
|
The Hinting Task. (Corcoran et al. 1995; Gil et al. 2012)
Time Frame: 6 months follow-up
|
The Scale assess Theory of Mind.
Possible range: 0-12.
Higher values represent a better outcome
|
6 months follow-up
|
Emotional Recognition Test Faces. (Baron-Cohen et al. 1997)
Time Frame: baseline
|
20 photographs that express ten basic and ten complex emotions.Possible range: 0-20.
Higher values represent a better outcome
|
baseline
|
Emotional Recognition Test Faces. (Baron-Cohen et al. 1997)
Time Frame: immediately after the intervention
|
20 photographs that express ten basic and ten complex emotions.
Possible range: 0-20.
Higher values represent a better outcome
|
immediately after the intervention
|
Emotional Recognition Test Faces. (Baron-Cohen et al. 1997)
Time Frame: 6 months follow-up
|
20 photographs that express ten basic and ten complex emotions.Possible range: 0-20.
Higher values represent a better outcome
|
6 months follow-up
|
MASC. (Lahera et al.2014).
Time Frame: immediately after the intervention
|
A Movie for the Assessment of Social Cognition. Spanish Validation. 46 multiple-choice questions about the emotions, thoughts or intentions of the protagonists. Only one answer out of four is correct. The four choices of each answer include, (1) correct attribution of ToM to the characters of the film, (2) excessive ToM errors (a mental state that is attributed when there is no reason to), (3) reduced ToM errors (a present mental state that is not attributed) and (4) total absence of mental inference (a physical causality attribution instead of a mental state). These errors could be classified as overmentalization, undermentalization and absence of mentalization. |
immediately after the intervention
|
Other Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
SFS. Social Functioning Scale.(Birchwood et al, 1990; Torres y Olivares, 2000).
Time Frame: baseline
|
This scale assess social functioning in people with psychotic disorders.
Range: 45-195
|
baseline
|
SFS. Social Functioning Scale.(Birchwood et al, 1990; Torres y Olivares, 2000).
Time Frame: immediately after the intervention
|
This scale assess social functioning in people with psychotic disorders.Range: 45-195
|
immediately after the intervention
|
SFS. Social Functioning Scale.(Birchwood et al, 1990; Torres y Olivares, 2000).
Time Frame: 6 months follow-up
|
This scale assess social functioning in people with psychotic disorders.Range: 45-195
|
6 months follow-up
|
WCST(Wisconsin Card Sorting Test, Bergs et al, 1948)
Time Frame: baseline
|
measure of executive function.
Categories completed and perseverative errors.
Higher values represent a better outcome.
|
baseline
|
WCST(Wisconsin Card Sorting Test, Bergs et al, 1948)
Time Frame: immediately after the intervention
|
measure of executive function.
Categories completed and perseverative errors.
Higher values represent a better outcome.
|
immediately after the intervention
|
WCST(Wisconsin Card Sorting Test, Bergs et al, 1948)
Time Frame: 6 months follow-up
|
measure of executive function.
Categories completed and perseverative errors.
Higher values represent a better outcome.
|
6 months follow-up
|
Test Stroop (Stroop, 1935)
Time Frame: baseline
|
flexibility and inhibition of automatic responses.Higher values represent a better outcome.
|
baseline
|
Test Stroop (Stroop, 1935)
Time Frame: immediately after the intervention
|
flexibility and inhibition of automatic responses.Higher values represent a better outcome.
|
immediately after the intervention
|
Test Stroop (Stroop, 1935)
Time Frame: 6 months follow-up
|
flexibility and inhibition of automatic responses.Higher values represent a better outcome.
|
6 months follow-up
|
TMT A B (Trail Making Test, Reitan, 1993)
Time Frame: baseline
|
visual attention and task switching.
Higher values represent a worse outcome.
|
baseline
|
TMT A B (Trail Making Test, Reitan, 1993)
Time Frame: immediately after the intervention
|
visual attention and task switching.
Higher values represent a worse outcome.
|
immediately after the intervention
|
TMT A B (Trail Making Test, Reitan, 1993)
Time Frame: 6 months follow-up
|
visual attention and task switching.
Higher values represent a worse outcome.
|
6 months follow-up
|
CPT-IP (Continous Performance Test, Matrics)
Time Frame: baseline
|
measure of attention.
Higher values represent a better outcome.
|
baseline
|
CPT-IP (Continous Performance Test, Matrics)
Time Frame: 6 months follow-up
|
measure of attention.Higher values represent a better outcome.
|
6 months follow-up
|
TAVEC (Verbal Learning Test), Benedet and Aleixandre 1998)
Time Frame: baseline
|
measure of verbal memory.Higher values represent a better outcome.
|
baseline
|
TAVEC (Verbal Learning Test), Benedet and Aleixandre 1998)
Time Frame: 6 months follow-up
|
measure of verbal memory.
Higher values represent a better outcome.
|
6 months follow-up
|
WAIS-III (Weschler Adults Intelligence Scale, Wechsler 1955)
Time Frame: baseline
|
vocabulary subscale.
Higher values represent a better outcome.
|
baseline
|
WAIS-III (Weschler Adults Intelligence Scale, Wechsler 1955)
Time Frame: baseline
|
digits subscale.
Higher values represent a better outcome.
|
baseline
|
WAIS-III (Weschler Adults Intelligence Scale, Wechsler 1955)
Time Frame: immediately after the intervention
|
digits subscale.
Higher values represent a better outcome.
|
immediately after the intervention
|
WAIS-III (Weschler Adults Intelligence Scale, Wechsler 1955)
Time Frame: 6 months follow-up
|
digits subscale.
Higher values represent a better outcome.
|
6 months follow-up
|
Collaborators and Investigators
Sponsor
Collaborators
Study record dates
Study Major Dates
Study Start (ACTUAL)
Primary Completion (ACTUAL)
Study Completion (ACTUAL)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (ACTUAL)
Study Record Updates
Last Update Posted (ACTUAL)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- PI14/00044
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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