The following is a summary of the “A pilot randomized controlled trial comparing a novel compassion and metacognition approach for schizotypal personality disorder with a combination of cognitive therapy and psychopharmacological treatment,” published in the February 2022 issue of Psychiatry by Cheli, et al.

Pervasive maladaptive behaviour is a hallmark of schizotypal personality disorder, which has been linked to an increased risk of schizophrenia. Effective psychosocial therapies are poorly understood. The purpose of this preliminary non-inferiority randomised controlled trial was to evaluate an unique kind of psychotherapy developed specifically for this problem with a combination of cognitive therapy and psychopharmacological treatment for this condition. Evolutionary Systems Treatment for Schizotypy, the old treatment, combined evolutionary theory, a metacognitive focus, and an emphasis on compassion.

Around 33 people were considered for inclusion, 24 were randomly assigned on a 1:1 basis, and 19 were used for statistical analysis. Around 6 months were spent undergoing treatment (24 sessions). Remission from diagnosis, pre-post improvements in general symptomatology, and metacognitive alterations were secondary outcomes to the primary outcome of change across nine assessments in personality pathology. The most important result indicated that the experimental treatment was not worse than the control. Conflicting findings were reported as secondary outcomes. 

Although there was no statistically significant difference between the 2 groups in terms of remission, those receiving experimental treatment demonstrated a greater decrease in overall symptomatology (η2 = 0.558) and an increased capacity for self-awareness (η2 = 0.734). The results of this pilot study were encouraging in terms of the potential of the proposed new technique. If they want to know which of the 2 treatments is more effective, they need to do a massive confirmatory trial.