Sex differences in neurocognitive response to metacognitive training in first-episode psychosis

Purpose Neurocognitive impairments are a core feature of psychosis and impact long-term outcomes. While sex differences in neurocognition have been observed in first-episode psychosis (FEP), findings remain mixed, and little is known about differential responses to metacognitive interventions. This...

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Detalles Bibliográficos
Autores: Verdaguer-Rodríguez, Marina|||0000-0001-9910-1220, Comas, Josep Oriol, López-Carrilero, Raquel|||0000-0003-4110-794X, Díaz-Cutraro, L.|||0000-0003-3985-2780, Espinosa, Victoria, Ruiz Delgado, Isabel, Barrigón, María Luisa|||0000-0002-2497-6353, Grasa, Eva|||0000-0003-1100-7489, Pousa Tomàs, Esther|||0000-0003-4423-6739, González-Higueras, Fermín|||0000-0002-0826-5981, Cid Colom, Jordi|||0000-0002-6406-0585, Lorente-Rovira, Esther, Barajas Vélez, Ana|||0000-0003-1103-9499, Ochoa, Susana|||0000-0001-6792-1080
Tipo de recurso: artículo
Fecha de publicación:2026
País:España
Institución:Universitat Autònoma de Barcelona
Repositorio:Dipòsit Digital de Documents de la UAB
Idioma:inglés
OAI Identifier:oai:ddd.uab.cat:325788
Acceso en línea:https://ddd.uab.cat/record/325788
https://dx.doi.org/urn:doi:10.1007/s00737-025-01637-3
Access Level:acceso abierto
Palabra clave:Psychosis
Cognition
Psychological Interventions
Gender
Intersectionality
Descripción
Sumario:Purpose Neurocognitive impairments are a core feature of psychosis and impact long-term outcomes. While sex differences in neurocognition have been observed in first-episode psychosis (FEP), findings remain mixed, and little is known about differential responses to metacognitive interventions. This study examined sex differences in the effectiveness of Metacognitive Training (MCT) on neurocognitive outcomes in FEP. Methods A total of 122 individuals with FEP were randomized to receive either MCT or psychoeducational intervention. Neurocognitive performance was assessed at baseline and at 6-month follow-up using a comprehensive battery (CPT-II, TMT, WCST, Stroop test, TAVEC, WAIS-III Digit Span). General Linear Models tested the effects of intervention, sex, and their interaction, both unadjusted and adjusted for covariates. Results MCT led to greater improvements than psychoeducation in immediate recall, processing speed, cognitive flexibility, inhibitory control, and attention. Improvements in immediate recall and Stroop Interference remained significant after adjustment, with Stroop performance also influenced by diagnosis. Across groups, men performed better in verbal memory, while women showed increased serial clustering in short-term recall, an effect that remained significant after adjustment. Notably, a group-by-sex interaction indicated that women receiving MCT experienced greater gains in short-term recall after controlling for covariates. Conclusions MCT enhances specific neurocognitive functions in FEP and shows promising effects for women in verbal memory processes. These findings underscore the importance of incorporating sex and diagnostic factors when tailoring early interventions for psychosis and highlight the potential of MCT as a personalized cognitive strategy.