The importance of personalizing the psychological treatment of psychosis
Summary
Schizophrenia and other psychotic disorders affect 2% of the population and have a significant impact on the functioning and quality of life of those affected. Although standard treatment includes antipsychotics, it is important to promote the inclusion of complementary psychological interventions such as metacognitive training (MCT), a therapy supported by international guidelines. MCT helps individuals identify and correct cognitive biases linked to psychotic symptoms and has demonstrated both short- and long-term benefits. This structured and flexible intervention is easily reproducible and adaptable to individual needs.
Along these lines, the international PERMEPSY project seeks to further personalize the psychological treatment of psychosis using technologies such as machine learning. The goal is to identify which individuals benefit most from mental health interventions, considering clinical, cognitive, biomarker, and sociodemographic factors. PERMEPSY has developed a digital platform based on data from over 700 people in five countries, which helps clinicians make personalized decisions. The project is currently in its recruitment and outreach phase. PERMEPSY represents a step forward toward personalized, effective, and innovative mental health medicine.
Psychotic disorders affect approximately 2% of the population and have a significant impact on the daily functioning of those affected. Currently, most people diagnosed with psychosis receive pharmacological treatment with antipsychotics. However, while these medications can reduce some symptoms, they do not always improve the overall functioning of the affected individual.
In this context, a growing number of studies highlight the need to include various psychological treatments. Different research studies are demonstrating how psychological treatment is effective in improving symptoms, even in the absence of pharmacological treatment; in some of these studies, up to 40% of people experience a significant improvement in their symptoms (Morrison et al., 2014).
Why is metacognitive training so useful in psychosis?
One of the most promising therapies is metacognitive training (MCT ), a specific psychological intervention for psychosis that has proven effective and is recommended by international guidelines such as NICE (2014) and WHO (2023). MCT focuses on reducing the cognitive biases that influence the onset and maintenance of psychotic symptoms and has shown positive results in multiple studies (Moritz et al., 2007; Gaweda et al., 2009; Moritz et al., 2011; Moritz et al., 2014; Briki et al., 2014; Andreou et al., 2017; Ochoa et al., 2017). Furthermore, the benefits of MCT are not only short-term: its therapeutic effects have been shown to persist even three years after treatment has ended, making it a key tool for long-term recovery.
Metacognitive training focuses on reducing cognitive biases that influence the onset and maintenance of psychotic symptoms, and has shown positive results in multiple studies.
The EMC is a manualized therapy, meaning it is structured in standardized modules with clear guidelines for practitioners. Each module includes specific materials (slides, activities, clinical examples) and focuses on a particular cognitive bias. Basic training can be completed in short workshops or online courses, and many materials are available free of charge in several languages, including Spanish, through the official website . Although the EMC was conceived as a standardized group intervention, its flexible structure allows for easy customization .
Metacognitive training: learning to think better
Personalize metacognitive training
Despite growing scientific evidence supporting the effectiveness of metacognitive training (MCT) in treating psychosis, many people still lack access to this intervention or do not experience consistent improvement. This reality poses a significant challenge for clinical practice. The vast majority of clinical and research staff agree that the treatment of individuals with psychosis should be personalized and tailored to their specific needs. However, in everyday practice, this personalization is not always implemented, whether due to a lack of resources, time, or specialized training. In this context, MCT emerges as one of the most versatile and effective therapeutic options.
Along these lines, the PERMEPSY project (Towards a Personalized Medicine Approach to Psychological Treatment for Psychosis) is underway. This international initiative is coordinated by the Parc Sanitari Sant Joan de Déu and funded by the ERAPerMed program and, in Spain, by the Carlos III Health Institute. Its main objective is to develop a personalized medicine approach to the psychological treatment of psychosis, using innovative technologies such as machine learning and adaptive digital platforms.
PERMEPSY has developed a digital platform capable of personalizing metacognitive training based on the individual characteristics of each person.
The project is based on a simple but important premise: not everyone responds the same way to available treatments. Therefore, it aims to offer a more personalized approach that takes into account factors such as:
• Clinical and cognitive characteristics.
• Individual biomarkers.
• Sociodemographic factors.
With this objective, PERMEPSY has developed a prototype digital platform based on data from over 700 people with psychosis in five countries. This platform personalizes metacognitive training according to each individual's characteristics, helping clinical staff make informed decisions based on the specific needs of each patient. The project is currently in its active recruitment phase.
Personalized medicine in the treatment of psychosis
PERMEPSY is much more than a scientific study; it's an initiative that seeks to transform lives through an innovative approach to mental health. By combining advanced technology with a deep human commitment, this project has the potential to redefine how we understand and treat people with psychosis. Initiatives like PERMEPSY offer new and innovative support through effective and personalized treatments. Science is advancing to improve our quality of life, and projects like this are proof of that.
If you are interested in participating in this project, you can register for the information session on May 23, 2025, through this link: https://forms.office.com/e/peaxutVXSF .
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