Issues in Rehabilitation of Cognitive Deficits in Schizophrenia: A Critical Review

Over the past 20 years, researchers have begun to examine whether remediation of cognitive deficits could improve cognitive performance in individuals with schizophrenia, using rehabilitation medicine models for traumatic brain injury. A number of recent meta-analyses have demonstrated that this type of intervention is of benefit, but numerous questions remain, including the crucial issue of whether improvement on cognitive measures corresponds to improvements on other tasks or to real-world functioning. Further, there has been little analysis of individual differences in response to cognitive remediation, despite increasing evidence for considerable heterogeneity of cognitive function in schizophrenia, ranging from near-normal cognitive function to global impairment. This article will provide a summary of the research in this area to date, and address many of the methodological issues that are relevant in studies on cognitive rehabilitation in schizophrenia, including a critical review of treatment and outcome variables.