Exploring sex-specific symptom trajectories in psychosis following metacognitive training (MCT): Evidence from a large-scale retrospective harmonized database
8 affiliations
- 1Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, Spain
- 2Grup MERITT, Fundació Sant Joan de Déu, Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain
- 3Consorcio de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
- 4Departament de Psicologia Clínica i de la Salut, Facultat de Psicologia, Universitat Autònoma de Barcelona, Bellaterra, Cerdanyola del Vallès, Barcelona, Spain
- 5University of Strasbourg, Inserm, UMR_S 1329, Strasbourg, France
- 6Department of Psychiatry and Psychotherapy, University Medical Center Hamburg, Hamburg, Germany
- 7Experimental Psychopathology Lab, Institute of Psychology, Polish Academy of Sciences, Warsaw, Poland
- 8Departamento de Psiquiatría, Escuela de Medicina, Facultad de Medicina, Universidad de Valparaíso, Valparaíso, Chile
Abstract
Sex-related differences in the clinical presentation and course of schizophrenia spectrum disorders are increasingly recognized, yet it remains unclear whether biological sex moderates response to psychological interventions. Metacognitive Training for psychosis is an evidence-based psychological intervention targeting cognitive biases associated with psychotic symptoms, but evidence regarding sex-specific treatment effects remain limited. The present study examined whether biological sex influences symptom trajectories following Metacognitive Training in individuals with schizophrenia spectrum disorders. We analyzed harmonized retrospective data from an international consortium (PERMEPSY) including participants who received Metacognitive Training for psychosis in routine clinical or research settings. The sample comprised 573 participants diagnosed with schizophrenia spectrum disorders across different stages of illness. Control group data was not available due to the retrospective nature of the data and a lack of a standardised control group among included datasets. Psychotic symptoms were assessed using the Positive and Negative Syndrome Scale, including positive, negative, general, and total symptom scores. Repeated-measures analyses of variance were conducted to examine the effects of time, sex, and their interaction on symptom change. Across the full sample, Metacognitive Training for psychosis was associated with significant reductions in positive, negative, general, and overall psychotic symptoms. However, no significant moderation of symptom change by biological sex was detected, indicating comparable symptom improvement in males and females across all symptom domains. These findings are consistent with prior evidence supporting MCT as a broadly applicable psychological intervention for psychosis, with comparable symptom changes observed in males and females following treatment. Although sex-related differences in baseline symptom profiles were observed, biological sex did not influence the trajectory of symptom change following treatment. These results support the generalizability of Metacognitive Training and point to the relevance of examining more nuanced sex-related factors in future research.
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BibTeX
@article{lamarca2026exploring,
title = {{Exploring sex-specific symptom trajectories in psychosis following metacognitive training (MCT): Evidence from a large-scale retrospective harmonized database}},
author = {Maria Lamarca and Adrien Goncalves and Steffen Moritz and Łukasz Gawęda and Vanessa Acuña and Caroline König and Fabrice Berna and Susana Ochoa},
journal = {PLOS One},
year = {2026},
month = sep,
doi = {10.1371/journal.pone.0356632},
url = {https://doi.org/10.1371/journal.pone.0356632},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Exploring sex-specific symptom trajectories in psychosis following metacognitive training (MCT): Evidence from a large-scale retrospective harmonized database
AU - Maria Lamarca
AU - Adrien Goncalves
AU - Steffen Moritz
AU - Łukasz Gawęda
AU - Vanessa Acuña
AU - Caroline König
AU - Fabrice Berna
AU - Susana Ochoa
PY - 2026
DA - 2026/09/21
JO - PLOS One
DO - 10.1371/journal.pone.0356632
UR - https://doi.org/10.1371/journal.pone.0356632
AB - Sex-related differences in the clinical presentation and course of schizophrenia spectrum disorders are increasingly recognized, yet it remains unclear whether biological sex moderates response to psychological interventions. Metacognitive Training for psychosis is an evidence-based psychological intervention targeting cognitive biases associated with psychotic symptoms, but evidence regarding sex-specific treatment effects remain limited. The present study examined whether biological sex influences symptom trajectories following Metacognitive Training in individuals with schizophrenia spectrum disorders. We analyzed harmonized retrospective data from an international consortium (PERMEPSY) including participants who received Metacognitive Training for psychosis in routine clinical or research settings. The sample comprised 573 participants diagnosed with schizophrenia spectrum disorders across different stages of illness. Control group data was not available due to the retrospective nature of the data and a lack of a standardised control group among included datasets. Psychotic symptoms were assessed using the Positive and Negative Syndrome Scale, including positive, negative, general, and total symptom scores. Repeated-measures analyses of variance were conducted to examine the effects of time, sex, and their interaction on symptom change. Across the full sample, Metacognitive Training for psychosis was associated with significant reductions in positive, negative, general, and overall psychotic symptoms. However, no significant moderation of symptom change by biological sex was detected, indicating comparable symptom improvement in males and females across all symptom domains. These findings are consistent with prior evidence supporting MCT as a broadly applicable psychological intervention for psychosis, with comparable symptom changes observed in males and females following treatment. Although sex-related differences in baseline symptom profiles were observed, biological sex did not influence the trajectory of symptom change following treatment. These results support the generalizability of Metacognitive Training and point to the relevance of examining more nuanced sex-related factors in future research.
SN - 1932-6203
ER -