Browsing by Author "Rocha, Nuno"
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- Assessing the efficacy and feasibility of providing metacognitive training for patients with schizophrenia by mental health nurses: a randomized controlled trialPublication . Pinho, Lara Guedes de; Sequeira, Carlos; Sampaio, Francisco; Rocha, Nuno; OZASLAN, ZEYNEP; Ferre‐Grau, CarmeAim: To evaluate the efficacy of metacognitive group training in reducing psychotic symptoms and improving cognitive insight and functions in people with schizophrenia.Design: Randomized controlled trial. It was carried out between July 2019-February 2020. Methods: Fifty-six patients with schizophrenia were enrolled and randomly as- signed to either a control group (N = 29) or a metacognitive training group (N = 27). Blinded assessments were made at baseline, 1-week post-treatment and at follow-up 3 months after treatment. The primary outcome measure was psychotic symptoms based on the Psychotic Symptom Rating Scales (PSYRATS). Secondary outcomes were assessed by the Beck Cognitive Insight Scale (BCIS), the Personal and Social Performance (PSP) scale and the World Health Organization Disability Assessment Schedule (WHODAS). Results: Completion at follow-up was high (92.86%). The intention-to-treat analy- ses demonstrated that patients in the metacognitive training group had significantly greater improvements of the Psychotic Symptom Rating Scales delusion score and total score and the Personal and Social Performance Scale, after 3 months, compared with the control group. The effect size was medium to large. The intention-to-treat analyses also demonstrated that patients in the metacognitive training group had significantly greater reductions of the Psychotic Symptom Rating Scales hallucination score and Beck Cognitive Insight Scale self-certainty score post-treatment, compared with the control group. The effect size was medium to large. Conclusion: The metacognitive training administered by psychiatric and mental health nurses was effective in ameliorating delusions and social functioning over time and it immediately reduced hallucinations post-treatment. Impact: Metacognitive training for treating psychosis in patients with schizophrenia is efficacious and administration is clinically feasible in the Portuguese context.
- "A capacidade de pensar no que os outros pensam" - teoria da mente na esquizofrenia: revisão da literaturaPublication . Rocha, Joana; Fernandes, Carlos; Rocha, NunoO uso da Linguagem envolve uma série de regras conversacionais que implica a capacidade de inferir sobre os estados mentais dos outros. Esta capacidade metacognitiva designa-se de Teoria da Mente (TM) e tem sido estudada mais rigorosamente nas últimas décadas. A literatura aponta que esta competência se encontra severamente perturbada na doença mental severa (e.g. Esquizofrenia), pelo que os objectivos do presente trabalho se resumem à caracterização da TM, da relação que esta estabelece com a linguagem, e como se encontra perturbada especificamente na Esquizofrenia. Parece também existir uma ligação relevante entre TM e os neurónios-espelho (Mirror Neurons) que fortalece esta discussão. Em relação à avaliação da TM, esta não é considerada uma tarefa linear, pelo que existem diferentes instrumentos para este fim, sendo que cada um incide numa competência específica de TM. Por último, dado que na Esquizofrenia existem défices ao nível da TM e no uso da linguagem, é também apontada a necessidade de incluir estas competências no desenho de programas de reabilitação psiquiátrica. The pragmatics use of language requires specific conversational rules that are related to the ability to attribute mental states to others. This meta-cognitive capacity has been largely studied in the last decades, and it is commonly defined as Theory of Mind (TM). Literature shows that TM is impaired in severe mental disorders (e.g. Schizophrenia), so the purpose of this paper is to define TM and it´s relation to language, and how it appears to be specifically impaired in Schizophrenia. It seems that there is also an important relation between TM and Mirror-Neurons, relevant to this discussion. Assessing TM has some difficulties and limitations, and there are several instruments designed to assess TM skills. As a conclusion, there are some references to the importance of cognitive remediation in these patients, because in schizophrenia we found deficits in theory of mind and language use, so these can be important targets of psychosocial treatments programs.