Predictors and Session-Specific Effects of Metacognitive Training for Depression (D-MCT)

Psychiatry Clin Neurosci. 2025 Nov 18. doi: 10.1111/pcn.13913. Online ahead of print.

ABSTRACT

OBJECTIVE: Cognitive biases contribute to symptoms of depression in both its primary diagnosis and comorbid expressions. Exploring the module-specific effects of Metacognitive Training for Depression (D-MCT) in patients with comorbid depression offers valuable insights into how the various D-MCT modules address shared mechanisms, paving the way for a better understanding of how it works for these patients.

METHOD: Participants with primarily comorbid depression were recruited on a specialized ward for OCD and anxiety-related disorders (N = 108). The study investigated the session-specific effects of each module of the D-MCT by linear mixed effect models (i) over the course of the intervention, (ii) within each session, and (iii) between sessions. Secondly, a Lasso regression analysis was performed to examine whether changes in cognitive biases in specific modules would predict overall change in depressive symptoms of the D-MCT.

RESULTS: The results indicated small effects for the change in beliefs about rumination (d = 0.49) and mind reading (d = 0.24) over the time of the intervention. Within-session analyses revealed several session-specific effects, including a change in maladaptive beliefs about rumination within the module on this topic, with a medium effect size (d = 0.67). The Lasso regression indicated the change in negative filter as a predictor for the change in depressive symptoms, but this was not confirmed by a subsequent linear regression analysis.

CONCLUSIONS: The results suggest that patients with comorbid depression might benefit from special emphasis on themes such as rumination that bridge the primary and comorbid diagnoses in groups with a high prevalence of OCD and an anxiety-related disorder.

PMID:41251007 | DOI:10.1111/pcn.13913