Metacognition in functional cognitive disorder- a potential mechanism and treatment target

被引:30
作者
Bhome, Rohan [1 ]
McWilliams, Andrew [2 ,3 ,4 ]
Huntley, Jonathan D. [1 ]
Fleming, Stephen M. [3 ,5 ]
Howard, Robert J. [1 ]
机构
[1] UCL, Div Psychiat, London, England
[2] Kings Coll London, Inst Psychiat Psychol & Neurosci, Dept Psychol Med, London, England
[3] UCL, Wellcome Ctr Human Neuroimaging, London, England
[4] UCL Inst Child Hlth, London, England
[5] Max Planck Univ Coll, London Ctr Computat Psychiat & Ageing Res, London, England
基金
英国惠康基金;
关键词
Functional cognitive disorder; metacognition; treatment; mechanism; MEMORY COMPLAINTS; OLDER-ADULTS; ABILITY; PERFORMANCE; METAMEMORY; ACCURACY; STYLE;
D O I
10.1080/13546805.2019.1651708
中图分类号
R749 [精神病学];
学科分类号
100205 ;
摘要
Introduction: Functional Cognitive Disorder (FCD) is common. Despite this, there is no evidence-based consensus on how to treat FCD. Poor metacognitive ability has been suggested as a key mechanism underlying the disorder. This paper evaluates the proposal that strategies which improve metacognition could provide a mechanistically plausible translational therapy. Methods: We reviewed the existing literature relating to metacognition in FCD, previous strategies to improve metacognitive ability in FCD and whether metacognitive performance can be modulated. Results: Though limited, there is evidence to suggest that metacognition is impaired in FCD. Converging evidence from neuroimaging studies suggests that metacognitive performance can be modulated. The effectiveness of existing strategies to improve metacognition including cognitive training, psychoeducation and lifestyle interventions have been equivocal. Recently, a potential treatment option has emerged in the form of a computer-based metacognitive training paradigm. Conclusions: There is an urgent need for effective treatments in FCD. Impaired metacognition may be a plausible therapeutic target but, in the first instance, further research is required to demonstrate deficits in "local" metacognitive ability in FCD patients when measured objectively. If so, clinical trials of interventions, such as computerised metacognitive training, are required to evaluate their effectiveness in improving FCD symptoms.
引用
收藏
页码:311 / 321
页数:11
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