Sex differences in neurocognitive response to metacognitive training in first-episode psychosis: Implications for personalized interventions
Por:
Verdaguer-Rodríguez, M., Comas, J.O., López-Carrilero, R., Díaz-Cutraro, L., Espinosa, V., Ruiz-Delgado, I., Barrigón, M.L., Grasa, E., Pousa, E., González-Higueras, F., Cid, J., Lorente-Rovira, E., Barajas, A., Ochoa, S.
Publicada:
1 ene 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. © 2026. The Author(s).
Filiaciones:
Verdaguer-Rodríguez, M.:
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, J.O.:
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.:
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
Díaz-Cutraro, L.:
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.:
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
Ruiz-Delgado, I.:
Unidad de Salud Mental Comunitaria Málaga Norte, Servicio Andaluz de Salud, Málaga, Spain
Barrigón, M.L.:
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
Grasa, E.:
Institut de Recerca Sant Pau (IR SANT PAU), Mental Health, Barcelona, Spain
Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), ISCIII, Madrid, Spain
Pousa, E.:
Institut de Recerca Sant Pau (IR SANT PAU), Mental Health, Barcelona, Spain
Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), ISCIII, Madrid, Spain
Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
González-Higueras, F.:
Hospital Universitario de Jaén, Servicio Andaluz de Salud, Jaén, Spain
Cid, J.:
Mental Health & Addiction Research Group, IdiBGi, Institut d'Assistencia Sanitària, Girona, Spain
Lorente-Rovira, E.:
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.:
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
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