Conclusion
psychiatric, SPD, schizotypal traits
REMISSION, SECONDARY, PATHOLOGY
In this pilot RCT on repeated measures we tested a non-inferiority hypothesis in comparing a specifically designed therapy for SPD and a presumably good psychiatric management. The former—namely, ESTS—was a recovery-oriented therapy integrating metacognitively oriented, compassion focused and evolutionary approaches and, the latter was a combination of CBT for PDs and psychopharmacological treatment.In spite of the low sample size and the preliminary nature of the study, results showed non-significant differences in primary outcome (i.e. personality pathology), whereas differences in secondary outcomes (i.e. remission from diagnosis, general symptomatology, and metacognition) possibly suggested a superiority of ESTS.The main implication of this research is that an adequately powered effectiveness trial on large sample size is needed to provide evidence about relative effectiveness of ESTS and CBT plus psychopharmacological treatment for those diagnosed with SPD. A further implication is that ESTS can be considered eligible to be evaluated in terms of clinical efficacy and utility in treating those with schizotypal traits. We suggest considering SPD as a treatable condition, metacognition and social safeness as target mechanisms, and evolutionary psychopathology as theoretical framework for the intervention.