Effectiveness of Metacognitive Training for Long-Term Hospitalized Patients with Schizophrenia: A Pilot Study with a Crossover Design

: Objective: This study aimed to explore the efficacy of metacognitive training (MCT) with long-term hospi talized patients with schizophrenia. Methods: Patients admitted to a hospital’s long-term care ward were randomly allocated to Groups A or B, and a crossover trial was performed. As intervention, 16 weekly MCT sessions were performed for 4 months as part of standard occupational therapy, and the participants’ cognitive functioning, psychiatric symptoms, overall functioning, and cogni tive bias were assessed at baseline, 4 months later, and 8 months later. Results: Twenty-two patients participated. Those who were discharged midway through the course, and those who withdrew their consent were excluded, and 17 individuals (Group A: n = 9; Group B, n = 8) completed their assessments 8 months later. No significant differences were seen in inter-group comparisons of the scores of various scales at the baseline. Four months and eight months later, a comparison between before and after MCT showed improvement tendencies for both groups in the participants’ cognitive function and psychiatric symptoms. A comparison of scores before and after the MCT intervention period, from all participants, showed significant improvement tendencies in their verbal memory and attention. Conclusion: MCT can be used for long-term hospitalization in patients with chronic-stage schizophrenia, and this study showed its potential to improve neurocognitive function. Going forward, there is a need to increase the sample size and examine the efficacy of MCT in more detail.