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Cognitive Remediation in Schizophrenia: Current Status and Future Perspectives

DOI: 10.1155/2013/156084

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Abstract:

Objectives. This study is aimed to review the current scientific literature on cognitive remediation in schizophrenia. In particular, the main structured protocols of cognitive remediation developed for schizophrenia are presented and the main results reported in recent meta-analyses are summarized. Possible benefits of cognitive remediation in the early course of schizophrenia and in subjects at risk for psychosis are also discussed. Methods. Electronic search of the relevant studies which appeared in the PubMed database until April 2013 has been performed and all the meta-analyses and review articles on cognitive remediation in schizophrenia have been also taken into account. Results. Numerous intervention programs have been designed, applied, and evaluated, with the objective of improving cognition and social functioning in schizophrenia. Several quantitative reviews have established that cognitive remediation is effective in reducing cognitive deficits and in improving functional outcome of the disorder. Furthermore, the studies available support the usefulness of cognitive remediation when applied in the early course of schizophrenia and even in subjects at risk of the disease. Conclusions. Cognitive remediation is a promising approach to improve real-world functioning in schizophrenia and should be considered a key strategy for early intervention in the psychoses. 1. Introduction Impairments in a wide range of cognitive abilities have been consistently reported in individuals with schizophrenia [1]. In the recent past, the Measurement and Treatment Research to Improve Cognition in Schizophrenia (MATRICS) project has identified seven distinct cognitive domains that are impaired in patients with schizophrenia: speed of processing, attention/vigilance, working memory, verbal and visual learning, reasoning and problem solving, and social cognition [2]. Moreover, in the third meeting of the Cognitive Neuroscience Treatment Research to Improve Cognition in Schizophrenia (CNTRICS) project, it was agreed that six areas or cognitive domains suffered impairment in schizophrenia: perception, working memory, attention, executive functions, long-term memory, and social cognition [3]. Social cognitive deficits include impairments in facial affect recognition, in perceiving and interpreting social cues, theory of mind (ToM), and the ability to make appropriate causal attributions for events [4]. Both neurocognitive and social cognitive deficits are thought to underlie the severe functional disabilities associated with schizophrenia, and several studies have

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