Cheli, SimoneCavalletti, VeronicaLysaker, Paul H.Dimaggio, GiancarloPetrocchi, NicolaChiarello, FrancescaEnzo, ConsueloVelicogna, FrancescoMancini, FrancescoGoldzweig, Gil2023-10-312023-10-312023-02-20Cheli S, Cavalletti V, Lysaker PH, et al. 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. BMC Psychiatry. 2023;23(1):113. Published 2023 Feb 20. doi:10.1186/s12888-023-04610-5https://hdl.handle.net/1805/36785Background: Schizotypal personality disorder is characterized by a pervasive pattern of maladaptive behavior that has been associated with the liability for schizophrenia. Little is known about effective psychosocial interventions. This pilot non-inferiority randomized controlled trial aimed to compare a novel form of psychotherapy tailored for this disorder and a combination of cognitive therapy and psychopharmacological treatment. The former treatment - namely, Evolutionary Systems Therapy for Schizotypy-integrated evolutionary, metacognitively oriented, and compassion focused approaches. Methods: Thirty-three participants were assessed for eligibility, twenty-four randomized on a 1:1 ratio, nineteen included in the final analysis. The treatments lasted 6 months (24 sessions). The primary outcome was change across nine measurements in personality pathology, the secondary outcomes were remission from diagnosis and pre-post changes in general symptomatology and metacognition. Results: Primary outcome suggested a non-inferiority of the experimental treatment in respect to control condition. Secondary outcomes reported mixed results. There was no significant difference in terms of remission, but experimental treatment showed a larger reduction of general symptomatology (η2 = 0.558) and a larger increase in metacognition (η2 = 0.734). Conclusions: This pilot study reported promising results about the effectiveness of the proposed novel approach. A confirmatory trial on large sample size is needed to provide evidence about relative effectiveness of the two treatment conditions.en-USAttribution 4.0 InternationalCompassionEvolutionEvolutionary systems therapy for schizotypyMetacognitionSchizotypal personality disorderSchizotypyArticle