Sex differences in neurocognitive response to metacognitive training in first-episode psychosis : Implications for personalized interventions
Verdaguer-Rodríguez, Marina (Universitat Autònoma de Barcelona. Departament de Psicologia Clínica i de la Salut)
Comas, Josep Oriol (Parc Sanitari Sant Joan de Déu)
López-Carrilero, Raquel (Parc Sanitari Sant Joan de Déu)
Díaz-Cutraro, L. (Parc Sanitari Sant Joan de Déu)
Espinosa, Victoria (Institut de Recerca Sant Joan de Déu)
Ruiz Delgado, Isabel (Servicio Andaluz de Salud. Unidad de Salud Mental Comunitaria Málaga Norte)
Barrigón, María Luisa (Hospital General Universitario Gregorio Marañón. Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM))
Grasa, Eva (Institut de Recerca Sant Pau)
Pousa Tomàs, Esther (Institut de Recerca Sant Pau)
González-Higueras, Fermín (Hospital Universitario de Jaén)
Cid Colom, Jordi (Institut d'Assistencia Sanitària, Girona. Mental Health & Addiction Research Group)
Lorente-Rovira, Esther (Hospital Clínic Universitari (València))
Barajas Vélez, Ana (Universitat Autònoma de Barcelona. Departament de Psicologia Clínica i de la Salut)
Ochoa, Susana
Spanish Metacognition Group

Data:	2026
Resum:	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.
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Matèria:	Psychosis ; Cognition ; Psychological Interventions ; Gender ; Intersectionality
Publicat a:	Archives of women's mental health, Vol. 29 (February 2026) , art. 36, ISSN 1435-1102

DOI: 10.1007/s00737-025-01637-3

16 p, 1.3 MB

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