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Delusions and Hallucinations in First-Episode Psychosis Patients: A Systematic Review on the Influence of Metacognition
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DOI：10.1016/j.neubiorev.2026.106735.png)
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Abstract
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• Metacognition can be assessed both directly and indirectly using clinical, cognitive insight and cognitive bias measures. • Hallucinations and delusions may be conceptualized as failures of metacognitive processes. • Poorer metacognitive abilities are associated with greater positive symptom severity. • Metacognitive training is associated with reductions in positive symptoms, thus improvements in quality of life. • A deeper understanding of the epistemological relationship between positive symptoms and altered metacognition, whether as a cause or a consequence, may inform more effective treatment and preventive interventions for psychotic disorders.
Keywords:
Metacognition
First-episode Psychosis
Hallucinations
Delusions
Clinical Insight
Cognitive Insight
Cognitive Bias
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