Heterogeneity in Response to MCT and Psychoeducation: A Feasibility Study Using Latent Class Mixed Models in First-Episode Psychosis

Abstract

Primer episodi de psicosi; Cognició social; Psicoeducació

First episode psychosis; Social cognition; Psychoeducation

Primer episodio de psicosis; Cognición social; Psicoeducación

Metacognitive training (MCT) is an effective treatment for psychosis. Longitudinal trajectories of treatment response are unknown but could point to strategies to maximize treatment efficacy during the first episodes. This work aims to explore the possible benefit of using latent class mixed models (LCMMs) to understand how treatment response differs between metacognitive training and psychoeducation. We conducted LCMMs in 28 patients that received MCT and 34 patients that received psychoeducation. We found that MCT is effective in improving cognitive insight in all patients but that these effects wane at follow-up. In contrast, psychoeducation does not improve cognitive insight, and may increase self-certainty in a group of patients. These results suggest that LCMMs are valuable tools that can aid in treatment prescription and in predicting response to specific treatments

This study was funded by the Instituto de Salud Carlos III, Spanish Government, (PI11/01347, PI14/00044 and PI18/00212); the Fondo Europeo de Desarrollo Regional (FEDER), Health Department of Catalonia, PERIS call (SLT006/17/00231); Progress and Health Foundation of the Andalusian Regional Ministry of Health (PI-0634/2011 and PI-0193/2014); Obra Social La Caixa (RecerCaixa call 2013), Obra Social Sant Joan de Déu, BML (RTI2018-100927-J-I00) administrated by Ministerio de Ciencia e Innovación (MCI, Spain), by the Agencia Estatal de Investigación (AEI, Spain), and by the European Regional Development Fund (FEDER, UE); Daniel Fernández has been supported by grant 2017 SGR 622 (GRBIO) administrated by the Departament d’Economia i Coneixement de la Generalitat de Catalunya (Spain) and by the Ministerio de Ciencia e Innovación (Spain) [PID2019-104830RB-I00/ DOI (AEI): 10.13039/501100011033]; and CIBER, Consorcio Centro de Investigación Biomédica en Red, Instituto de Salud Carlos III, Ministerio de Ciencia e Innovación.