Metacognitive training: a useful complement to community-based rehabilitation for schizophrenia patients in China

Qi Chen,Lifang Ren,Yajun Chen,Yueyun Sang,Jinping Wu,Menglei Zheng,Hanying Sun,Guolin Bian

doi:10.1186/s12888-021-03039-y

Abstract

BackgroundThe traditional general practitioner-based model (community-based rehabilitation [CBR]) for Chinese schizophrenia patients lacks sufficient content, usefulness, and theoretical basis for rehabilitation. Based on previous research, we postulate that Metacognitive Training (MCT) is effective in the community for schizophrenic patients.MethodA randomized controlled, assessor-blinded trial was conducted. A total of 124 schizophrenia patients were recruited from Ningbo China and were randomly assigned to an intervention or a control group. A general practitioner (GP) training plan was carried out before intervention. Intervention and control groups received two CBR follow-ups once a month, while the intervention group, received an additional eight once-a-in-week session of MCT. The Positive and Negative Syndrome Scale (PANSS), and the Psychotic Symptom Rating Scales (PSYRATS) were the primary outcome instruments, while the Quality of Life Scale (SQLS) was the secondary outcome instrument.ResultsIn the post-treatment between-groups assessment, the patients in the intervention group showed significantly more reductions on PSYRATS delusions, PSYRATS total, PANSS P6, PANSS core delusions, PANSS positive, PANSS negative, PANSS general and PANSS total, and a significant improvement in SQLS psychosocial aspect.ConclusionsThe study provides preliminary evidence for the usefulness of MCT as a complementary measure for community-based rehabilitation of schizophrenia patients.Trial registrationISRCTN, ISRCTN17333276. Registered 09 August 2020 - Retrospectively registered.

Highlights

The traditional general practitioner-based model for Chinese schizophrenia patients lacks sufficient content, usefulness, and theoretical basis for rehabilitation
While as in the intervention group, almost all the scales showed significant improved after the intervention, it indicated that the conventional community-based rehabilitation (CBR) maybe effective to some extent but was not as comprehensive as CBR + Metacognitive Training (MCT)
Given that there was no significant difference in P1 and P5, the difference in Positive and Negative Syndrome Scale (PANSS) core delusions may be mainly caused by P6

Summary

Introduction

The traditional general practitioner-based model (community-based rehabilitation [CBR]) for Chinese schizophrenia patients lacks sufficient content, usefulness, and theoretical basis for rehabilitation. Psychiatric disorders in the community: current challenges in China Schizophrenia is a serious and highly disabling psychiatric disorder [1]. Over 90% of schizophrenia patients in China live with their families (in the community) rather than in a psychiatric institution [4]. There is continuous demand for mental health and development (MHD) services at the community level [5]. Rehabilitation: from hospital-based to community-based Efforts to improve rehabilitation services have intensified recently in China. The MHD system in China has been hospital-based. Psychiatric physicians conduct short-term rehabilitation in the hospital and follow the discharged patients via phone calls. Distance prevents them from receiving hospital-based rehabilitation in several regions

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