Sex differences in neurocognitive response to metacognitive training in first-episode psychosis: Implications for personalized interventions.
Por:
Verdaguer M, Comas JO, López-Carrilero R, Diaz L, Espinosa V, Isabel Ruiz Delgado, Maria Luisa Barrigon Estevez, Eva Maria Grasa Bello, Esther Pousa Tomas, González-Higueras F, Jordi Cid Colom, ESTHER LORENTE ROVIRA, Barajas A and Ochoa S
Publicada:
9 feb 2026
Ahead of Print:
9 feb 2026
Resumen:
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.
Filiaciones:
Verdaguer M:
Etiopatogènia i tractament dels trastorns mentals greus (MERITT), Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain
Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain
Department of Clinical and Health Psychology, Universitat Autònoma de Barcelona, Cerdanyola del Vallès, Spain
Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), ISCIII, Madrid, Spain
Comas JO:
Etiopatogènia i tractament dels trastorns mentals greus (MERITT), Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain
Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain
López-Carrilero R:
Etiopatogènia i tractament dels trastorns mentals greus (MERITT), Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain
Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain
Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), ISCIII, Madrid, Spain
Diaz L:
Etiopatogènia i tractament dels trastorns mentals greus (MERITT), Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain
Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain
Fundació Hospitalària de Mollet, Hospital de Mollet, Mollet del Vallès, Spain
Espinosa V:
Etiopatogènia i tractament dels trastorns mentals greus (MERITT), Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain
Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain
Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), ISCIII, Madrid, Spain
Isabel Ruiz Delgado:
Unidad de Salud Mental Comunitaria Málaga Norte, UGC Salud Mental Carlos Haya, Servicio Andaluz de Salud, Málaga, Spain
Maria Luisa Barrigon Estevez:
Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), ISCIII, Madrid, Spain
Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, IiSGM, School of Medicine, Universidad Complutense., Madrid, Spain
Eva Maria Grasa Bello:
Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), ISCIII, Madrid, Spain
Mental Health, Institut de Recerca Sant Pau (IR SANT PAU), Barcelona, Spain
Esther Pousa Tomas:
Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), ISCIII, Madrid, Spain
Mental Health, Institut de Recerca Sant Pau (IR SANT PAU), Barcelona, Spain
Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
González-Higueras F:
Hospital Universitario de Jaén, Servicio Andaluz de Salud, Jaén, Spain
Jordi Cid Colom:
Mental Health & Addiction Research Group, IdiBGi, Institut d'Assistencia Sanitària, Girona, Spain
ESTHER LORENTE ROVIRA:
Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), ISCIII, Madrid, Spain
Hospital Clínico Universitario de Valencia, , Valencia, Spain
Barajas A:
Department of Clinical and Health Psychology, Universitat Autònoma de Barcelona, Cerdanyola del Vallès, Spain
Serra Húnter Programme, Generalitat de Catalunya, Barcelona, Spain
Ochoa S:
Etiopatogènia i tractament dels trastorns mentals greus (MERITT), Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain
Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain
Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), ISCIII, Madrid, Spain
Open Access
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