Comparison of the Efficacy of Metacognitive Training and a Psychoeducational Programme for Patients with Depression

Background. Despite the widespread application and established efficacy of both psychoeducational programmes and metacognitive training for patients with depression, the lack of direct comparative studies on their effectiveness leaves a significant gap in clinical practice.

Objective. The objective of this study is to conduct a comparative analysis of the therapeutic effects of a psychoeducational programme and metacognitive training in patients experiencing a depressive episode, recurrent depressive disorder, and bipolar affective disorder.

Study Participants. A total of 81 patients participated in the study: 29 men and 52 women, all diagnosed with a current depressive episode (mean Beck Depression Inventory score: 27.8). The mean age of participants was 30.7 years.

Methods. A comparative study was conducted to evaluate the effectiveness of two group interventions in inpatients with depression: metacognitive training and a psychoeducational programme. Assessments were performed at three time points: before the intervention, immediately after completion, and at a follow-up 6 months later. Psychopathological symptoms were assessed using the Beck Depression Inventory (BDI), the Apathy Evaluation Scale, Self-rated version (AES-S), and the Symptom Checklist-90-Revised (SCL-90-R). Individual psychological characteristics were evaluated with the Dysfunctional Attitude Scale (DAS), the Mindful Attention Awareness Scale (MAAS), the Metacognitions Questionnaire-30 (MCQ-30), and the Ways of Coping Questionnaire (WCQ). Data were analysed using the Mann-Whitney U test and the Wilcoxon signed-rank test.

Results. Both group interventions demonstrated a reduction in depressive symptoms immediately post-intervention and at the 6-month follow-up. Metacognitive training demonstrates superiority in correcting maladaptive metacognitions: it reduces dysfunctional beliefs, increases adaptive coping strategies (planning in problem-solving and others), and maintains its effectiveness at follow-up. The psychoeducational programme affects the reduction of belief in the need to thought control selectively.

Conclusions. Both programmes were associated with a reduction in depressive symptoms; however, metacognitive training demonstrated a more pronounced and sustained effect in modifying deeper structures, such as dysfunctional and metacognitive beliefs, which, in turn, contribute to the chronicity of depression.

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