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Combined Neurocognitive And Metacognitive Rehabilitation In Schizophrenia: Effects On Bias Against Disconfirmatory Evidence

Published online by Cambridge University Press:  15 April 2020

M. Buonocore*
Affiliation:
Department of Clinical Neurosciences, IRCCS San Raffaele Scientific Institute, via Stamira d’Ancona 20, 20127Milan, Italy
M. Bosia
Affiliation:
Department of Clinical Neurosciences, IRCCS San Raffaele Scientific Institute, via Stamira d’Ancona 20, 20127Milan, Italy Center for Neurolinguistics and Theoretical Syntax (NeTS), Institute for Advanced Study, IUSS, Pavia, Italy
R. Riccaboni
Affiliation:
Department of Clinical Neurosciences, IRCCS San Raffaele Scientific Institute, via Stamira d’Ancona 20, 20127Milan, Italy
M. Bechi
Affiliation:
Department of Clinical Neurosciences, IRCCS San Raffaele Scientific Institute, via Stamira d’Ancona 20, 20127Milan, Italy
M. Spangaro
Affiliation:
Department of Clinical Neurosciences, IRCCS San Raffaele Scientific Institute, via Stamira d’Ancona 20, 20127Milan, Italy Università Vita -Salute San Raffaele, Milan, Italy
M. Piantanida
Affiliation:
Department of Clinical Neurosciences, IRCCS San Raffaele Scientific Institute, via Stamira d’Ancona 20, 20127Milan, Italy
F. Cocchi
Affiliation:
Department of Clinical Neurosciences, IRCCS San Raffaele Scientific Institute, via Stamira d’Ancona 20, 20127Milan, Italy
C. Guglielmino
Affiliation:
Department of Clinical Neurosciences, IRCCS San Raffaele Scientific Institute, via Stamira d’Ancona 20, 20127Milan, Italy
L. Bianchi
Affiliation:
Department of Clinical Neurosciences, IRCCS San Raffaele Scientific Institute, via Stamira d’Ancona 20, 20127Milan, Italy
E. Smeraldi
Affiliation:
Department of Clinical Neurosciences, IRCCS San Raffaele Scientific Institute, via Stamira d’Ancona 20, 20127Milan, Italy Università Vita -Salute San Raffaele, Milan, Italy
R. Cavallaro
Affiliation:
Department of Clinical Neurosciences, IRCCS San Raffaele Scientific Institute, via Stamira d’Ancona 20, 20127Milan, Italy
*
Corresponding author. E-mail address:[email protected] (M. Buonocore).
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Abstract

Background

A Metacognitive Training for Schizophrenia patients (MCT) was developed to target the cognitive biases that characterize the illness. Results suggest positive MCT effects encompassing several aspects of psychopathology and subjective well-being. There are still open questions concerning the effect on different cognitive biases and the interplay between them and both psychopathology and neurocognition. Specifically, the bias against disconfirmatory evidence (BADE) has never been tested in previous trials on MCT. In this study we evaluated the feasibility of MCT combined with a cognitive remediation therapy (CACR) in schizophrenia and its effect on BADE. Moreover, we investigated the relationships between BADE and both neuropsychology and psychopathology, taking into account mutual influences on the degree of improvement.

Methods

Fifty-seven schizophrenia outpatients were randomly assigned to CACR + control group or MCT+CACR and assessed at baseline and after treatment for psychopathology, neurocognition and BADE.

Results

After MCT+CACR patients showed significantly greater improvements on BADE. Although BADE baseline performances correlated with several cognitive domains, no association was found between BADE improvement and neurocognitive nor psychopathological measures.

Conclusions

This study enlightened for the first time the efficacy of MCT+CACR on BADE in schizophrenia, suggesting the importance to develop a more specific intervention tailored on individual needs of patients.

Type
Original article
Copyright
Copyright © Elsevier Masson SAS 2015

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