Metacognitive functioning predicts positive and negative symptoms over 12 months in first episode psychosis

McLeod, H. J. , Gumley, A. I. , MacBeth, A., Schwannauer, M. and Lysaker, P. H. (2014) Metacognitive functioning predicts positive and negative symptoms over 12 months in first episode psychosis. Journal of Psychiatric Research, 54, pp. 109-115. (doi: 10.1016/j.jpsychires.2014.03.018) (PMID:24725651)

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The negative symptoms of schizophrenia are a major source of impairment and distress but both pharmacological and psychological treatment options provide only modest benefit. Developing more effective psychological treatments for negative symptoms will require a more sophisticated understanding of the psychological processes that are implicated in their development and maintenance. We extended previous work by demonstrating that metacognitive functioning is related to negative symptom expression across the first 12 months of first episode psychosis (FEP). Previous studies in this area have either been cross-sectional or have used much older participants with long-standing symptoms. In this study, forty-five FEP participants were assessed three times over 12 months and provided data on PANSS rated symptoms, premorbid adjustment, metacognitive functioning, and DUP. Step-wise linear regression showed that adding metacognition scores to known predictors of negative symptoms (baseline symptom severity, gender, DUP, and premorbid academic and social adjustment) accounted for 62% of the variance in PANSS negative symptom scores at six months and 38% at 12 months. The same predictors also explained 47% of the variance in positive symptoms at both six and 12 months. However, exploration of the simple correlations between PANSS symptom scores and metacognition suggests a stronger univariate relationship between metacognition and negative symptoms. Overall, the results indicate that problems with mental state processing may be important determinants of negative symptom expression from the very early stages of psychosis. These results provide further evidence that metacognitive functioning is a potentially relevant target for psychological interventions.

Item Type:Articles
Glasgow Author(s) Enlighten ID:MacBeth, Mr Angus and McLeod, Professor Hamish and Schwannauer, Dr Matthias and Gumley, Professor Andrew
Authors: McLeod, H. J., Gumley, A. I., MacBeth, A., Schwannauer, M., and Lysaker, P. H.
College/School:College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Mental Health and Wellbeing
Journal Name:Journal of Psychiatric Research
ISSN (Online):1879-1379
Copyright Holders:Copyright © 2014 Elsevier Ltd.
First Published:First published in Journal of Psychiatric Research 54:109-115
Publisher Policy:Reproduced in accordance with the copyright policy of the publisher.

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Project CodeAward NoProject NamePrincipal InvestigatorFunder's NameFunder RefLead Dept
410331Glasgow Edinburgh First Episode Study - how does engagement with services mediate symptomatic, emotional and quality of life outcomes.Andrew GumleyScottish Executive Health Department (SEHHD-CSO)CZH/4/295IHW - MENTAL HEALTH & WELLBEING