Abstract

Background: Meta-cognitive Training (MCT) is a promising therapeutic approach for schizophrenia. However, the extent to which demographic factors influence its efficacy in reducing psychotic symptoms and cognitive biases, as well as enhancing cognitive insight, needs further examination. Methods: A comprehensive search of databases: PubMed, PsycINFO, Scopus, (2007-November 2024) published only in English was conducted. Thirty-seven studies (81 % randomized, 19 % non-randomized trials) were included. Inclusion criteria were participants with a diagnosis of schizophrenia spectrum or related psychotic disorders, and there were no sex, gender, race, or ethnicity restrictions. We analyzed the influence of demographic factors on the efficacy of MCT, and the meta-regression analyses were conducted for variables including sex, age, duration of illness, and years of education. Results: MCT significantly reduced positive symptoms (d = ?0.40; p < 0.001), delusions (d = ?0.41; p < 0.001), and improved cognitive insight (d = 0.28; p < 0.05). Women benefit more in cognitive insight in self-reflectiveness scale (d = ?0.27; p = 0.05). However, no statistically significant gender differences were observed in other domains. Furthermore, no significant results were observed for other sociodemographic variables under study. Conclusions: MCT has been demonstrated to be an effective therapeutic method in the reduction of symptoms associated with schizophrenia, with the impact of demographic factors being limited. The enhancement of cognitive insight, particularly in the domains of self-reflectiveness and self-confidence, has been demonstrated in women. Future research should consider individual differences, particularly in the context of gender to advance personalized therapeutic approaches and optimize psychological interventions. © 2025 The Authors