Cognitive remediation therapy of social cognition in schizophrenia: A critical review

Purpose: To determine whether cognitive remediation therapy improves social cognition in patients with schizophrenia. Method: We reviewed the studies assessing the effect of cognitive remediation therapy on social cognition deficits in patients with schizophrenia. Results: To date, a small number of reports on cognitive remediation therapies to improve social cognition in these patients have been published. These programs targeted either broad social cognition, or more specific processes, such as emotion recognition and theory of mind. The results demonstrated improved performance on social cognition tasks in patients who received cognitive remediation therapies. However, when their performance was compared to that of a control group, significant differences were not always observed. The impact of cognitive remediation therapies on clinical symptoms is unclear. Conclusions: Definite conclusions cannot be drawn based on these studies. We discuss these results and propose avenues for future research. In particular, we address some aspects of the therapies, such as their duration, their format and the exercises that could be tested. Moreover, we suggest alternative indices to cognitive measures that would estimate the impact of cognitive remediation therapies on deficits observed in patients with schizophrenia.