Cognitive Remediation

Cognitive remediation is much more popular in the US than the UK (Turkington, Dudley & Warman, 2004). It is a rehabilitative approach, which has traditionally been applied to cognitive deficits in stroke and traumatic head injuries, with good evidence (Cicerone et al., 2000). Therapists using this approach hope to correct the cognitive deficits of schizophrenia, which affect neuropsychological functioning in the affected individuals. Studies show improvement in the laboratory environment, but do not appear to generalise to patients' own environment (Lehman et al., 2004). Trials of cognitive remediation have focussed on attention, verbal memory, visual memory and executive functioning. Although there are few positive results, a meta-analysis of pooled data did not show clear differences between cognitive remediation and controls (Pilling et al., 2002a). Moreover, trials are small in size and not adequately controlled for medication effects. Perhaps the mechanisms of cognitive deficits in schizophrenia are different from that induced by lesions. The disturbed functioning of an individual with schizophrenia cannot all be explained by cognitive dysfunction, therefore it makes sense to use remediation strategies in combination with other therapeutic inputs.

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