RESUMO
Background: More than half of women with psychosis take care of their children despite the difficulties caused by the disease. Additionally, these kids have a higher risk of developing a mental health disorder. However, no interventions have been developed to meet these needs. Metacognitive Training (MCT) is a psychological intervention that has demonstrated its efficacy in improving cognitive insight, symptom management and social cognition in people with first-episode psychosis (FEP). Additionally, MCT has shown better results in women than men with FEP. This study aims to adapt and evaluate the efficacy of MCT-F in mothers and adolescent children in an online group context with the main purpose of improving family relationships, cognitive awareness and symptoms in women with psychosis and increase their children's knowledge of the disease and their functioning. As secondary objectives, it also aims to evaluate improvements in metacognition, social cognition, symptoms, protective factors and self-perception of stigma. Materials and methods: A quasi-experimental design with participants acting as their own control will be carried out. Forty-eight mothers with psychosis and their adolescent children (between 12 and 20 years old) recruited from a total of 11 adult mental health care centers will receive MCT-F. Participants will be evaluated 11 weeks before the intervention (T1), at baseline (T2), and post-intervention (T3) with a cognitive insight scale, as a primary outcome. Measures of metacognitive and social cognition, symptoms, cognitive functioning, family and social functioning, protective factors (self-esteem, resilience, and coping strategies) and self-perceived stigma will be addressed as secondary outcomes. Assessment will also address trauma and attachment in mothers and, lastly, the feasibility and acceptability of MCT-F in both participant groups. Discussion: This will be the first investigation of the efficacy, acceptability, and viability of the implementation of MCT-F. The results of this study may have clinical implications, contributing to improving mothers' with psychosis and adolescents' functioning and better understanding of the disease, in addition to the possible protective and preventive effect in adolescents, who are known to be at higher risk of developing severe mental disorders.Clinical trial registration:https://clinicaltrials.gov/, identifier [NCT05358457].
RESUMO
Over half of women with psychosis are mothers. Research suggests that mothers with psychosis face unique challenges affecting both their mental health prognosis and their relationship with their children. Moreover, those children have a higher risk of developing a mental disorder. Notwithstanding, interventions specifically tailored to these families remain largely uncovered. Metacognitive Training (MCT) has demonstrated its efficacy in improving cognitive insight, symptom management, and social cognition in people with psychosis. However, there is no evidence of the efficacy of MCT in a family setting (MCT-F). This study describes the first adaptation of MCT for mothers with psychosis and their adolescent children in an online group setting. The phases (assessment, decision, adaptation, production, topical experts' integration) of the ADAPT-ITT model were systematically applied through a participatory approach (n = 22), including a first-person perspective and involving qualitative (e.g., topical expert literature review and consensus groups, interviews, thematic analyses) and quantitative methods. While MCT's core components were retained, participants guided adaptations both in content and delivery. The findings suggest the importance of community engagement and sharing decision-making processes to demonstrate the acceptability and feasibility of the adapted intervention. Employing a structured approach such as the ADAPT-ITT model ensures readiness of the new training for efficacy trials.
RESUMO
Tras decretarse el estado de alarma y el confinamiento por la amenaza del COVID-19, el acceso a los servicios de salud mental y recursos psicosociales se vio obstaculizado, incluso interrumpido.Un colectivo especialmente en riesgo es el de pacientes diag-nosticados de Trastorno Mental Grave. Estos presentan una serie de características que los hace más vulnerables a padecer un em-peoramiento en su salud mental.Desde el Hospital de Día para primeros brotes psicóticos de Pontones se intentó mantener la atención y el seguimiento estre-cho de los pacientes mediante la reestructuración del programa de tratamiento, optando por una intervención terapéutica alternativa mixto (con atención individual presencial y telefónica y terapias grupales por videoconferencia).El objetivo de este trabajo es dar a conocer la experiencia de la implementación de la telemedicina en nuestro HD como res-puesta a la emergencia sanitaria que ocasionó la pandemia, así como recoger el programa de actividades que se desarrollaron y el nivel de satisfacción con el tratamiento recibido de los pacientes que participaron.(AU)
Following the state of alarm and containment due to the CO-VID-19 threat, access to mental health services and psychosocial resources was hampered, even interrupted.A particularly at-risk group is that of patients diagnosed with Severe Mental Disorder. They present a series of characteristics that make them more vulnerable to a worsening of their mental health.From the Day Hospital for first psychotic outbreaks in Pontones we tried to maintain the attention and close monitoring of patients by restructuring the treatment programme, opting for a mixed al-ternative therapeutic intervention (with individual face-to-face and telephone attention and group therapies by videoconference).The aim of this paper is to report on the experience of implemen-ting telemedicine in our HD as a response to the health emergency caused by the pandemic, as well as to record the programme of activities that were developed and the level of satisfaction with the treatment received by the patients who participated.(AU)