Psychological interventions to improve cognitive biases in people with schizophrenia: A systematic review

Introduction: Individuals with schizophrenia commonly exhibit cognitive biases that are related to the disorder's symptoms. Objective: To review the current evidence on the characteristics and efficacy of psychological interventions targeting cognitive biases in individuals with schizophrenia. Method: Systematic review registered in PROSPERO. A bibliographic search was conducted in PsycINFO, PubMed, Scopus, and Web of Science up to January 2024. The search focused on quantitative studies using the following keyword sequence: (schizophreni* OR psychosis OR psychoses OR psychotic*) AND (cogniti* OR think*) AND (bias* OR error*) AND (treatment OR therapy OR intervention OR training). Results: A total of 38 studies assessed psychological interventions targeting cognitive biases in schizophrenia, with most focusing on Metacognitive Training (MCT). These interventions were found to significantly improve cognitive biases and positive symptoms, with promising effects on other symptoms,such as insight, negative symptoms, or self-esteem. Conclusions: The evidence linking cognitive biases to schizophrenia symptomatology is reinforced. Additionally, it is shown that improving cognitive biases may be an important therapeutic goal in the treatment of the disorder.