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This page is an AI-assisted Turkish summary of the study presented at the 26th World Congress of Psychiatry. The study belongs to the presenting authors; please refer to the original source when citing it.

EV0038

Metacognitive mechanisms as a treatment target in alcohol use disorder: findings from a randomized controlled trial

METACOGNITIVE MECHANISMS AS TREATMENT TARGETS IN ALCOHOL USE DISORDER: FINDINGS FROM A RANDOMIZED CONTROLLED TRIAL

Group-based metacognitive therapy produced reductions in depression, alcohol-related metacognitions, and alcohol use in the intervention arm that were maintained at the 3-month follow-up; the group-by-time interaction was significant only for depression.

The study aimed to evaluate the effects of group-based metacognitive therapy (MCT), which directly targets dysfunctional metacognitions in alcohol use disorder (AUD), against a waiting-list control; secondary aims were to examine depression, alcohol use, craving, and the maintenance of effects at 3 months. The randomized controlled trial enrolled 37 inpatients diagnosed with AUD (intervention n=23, control n=14); all four treatment dropouts occurred in the intervention arm and were included in the intention-to-treat analysis. The intervention group received eight 100-minute sessions of group MCT over 5 weeks; the content covered attention training, detached mindfulness, psychoeducation on the S-REF model of AUD, craving, alcohol-related metacognitions, cognitive biases, and relapse prevention. Assessments at baseline (T1), 1 week after the intervention (T2), and the 3-month follow-up (T3) were analyzed using linear mixed-effects models. Alcohol use symptoms (AUDIT) improved in both arms, with the greatest reduction observed in the intervention arm between T1 and T3 (p=0.002; d=-0.96; within-group t=-5.59; p<0.001; p<0.01 in the control arm). Depressive symptoms (BDI-II) decreased significantly in the intervention arm across all comparisons (within-group T1 to T3 t=-3.27; p<0.01), and the group-by-time interaction was significant between T1 and T3 (p=0.018). Negative alcohol-related metacognitions (NAMS) decreased in both arms (p<0.001; within-group t=-3.77; p<0.01; largest effect in the intervention arm, d=-1.19), but the group-by-time interaction was not significant (p=0.52); positive alcohol-related metacognitions (PAMS) decreased only in the intervention arm (T1 to T3 p=0.009; within-group t=-5.75; p<0.001; group-by-time interaction p=0.018), while MCQ-30 scores remained unchanged. The authors consider group MCT a feasible approach to targeting metacognitive mechanisms in AUD; they identify the small sample (n=37), unequal arm sizes (23 versus 14), single-center and unblinded design, and treatment dropouts occurring exclusively in the intervention arm as limitations.

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