Cognitive Impairment in Schizophrenia: The Role of Cognitive Rehabilitation
摘要
Cognitive impairment represents one of the core features of schizophrenia, with an important negative impact on several real-world functional outcomes: as such, it has become a key target in the treatment and in the rehabilitation process of schizophrenia spectrum disorders. Antipsychotic medications that are consistently effective in managing positive symptoms do not provide substantial benefits as regards cognitive performance. Furthermore, new medications that specifically target cognitive impairment in schizophrenia are not yet available for use in everyday clinical settings. In this scenario, psychosocial interventions that target cognitive performance represent the most effective treatment for cognitive impairment in people with schizophrenia. Among these, cognitive remediation represents the intervention with the most consistent evidence of effectiveness. In the present chapter, the features, the evidence of effectiveness, and the core elements of cognitive remediation, as well as future research and clinical implications, will be reported and discussed. Cognitive remediation currently represents the psychosocial intervention with the highest degree of recommendation in the European Psychiatric Association guidance dedicated to the treatment of cognitive impairment in schizophrenia. These recommendations are based on a wealth of evidence showing that cognitive remediation is effective not only in improving cognitive performance but also in improving the psychosocial functioning of people living with schizophrenia.