Cognitive remediation in schizophrenia: is it time yet?

Considerable effort has been directed toward identifying and conceptualizing information-processing deficits in schizophrenia and other psychotic disorders. The impressive gains in this field have made meaningful contributions to our understanding of the etiology and course of these disorders. This article considers whether the time is ripe to move beyond identification of these deficits to remediation of them. This move is far from a simple matter; it requires careful attention to theoretical frameworks and to the criteria for selecting certain cognitive deficits, among many, for remediation. A sparse and somewhat dated literature suggests that certain types of cognitive remediation, at least when defined in a narrow sense, are feasible with schizophrenic patients. This literature can reasonably justify continuing investigations on a modest scale. Specific questions for further studies include the following. 1) Which cognitive models provide a framework to guide cognitive interventions? 2) Which specific functions or levels of information processing should be targeted by cognitive interventions? 3) Are cognitive interventions effective? 4) Does the remediation of basic cognitive deficits generalize? A major strength of this area of investigation is the testability of the questions. Several research designs are tentatively suggested.