Chapter 12 - The importance of treating cognition in schizophrenia and other severe mental illnesses: background, strategies, and findings to date

Summary

Cognitive impairments have long been known to predict everyday functioning in people with various neuropsychiatric conditions. Impairments in everyday functioning lead to indirect costs of schizophrenia of over $50 billion per year. A further major issue is the increasingly appreciated fact that patients with bipolar disorder have similar deficits in cognition and everyday functioning, albeit with reduced prevalence of impairment. Dosing cognitive remediation requires careful consideration. Cognitive remediation may provide an excellent platform for enriching the cognitive environment of patients engaged in pharmacological trials to improve cognition. In contrast to symptoms of neuropsychiatric conditions, behavioral interventions have reliably produced better treatment effects than pharmacological interventions. However, combined therapies may result in better outcomes; with the meta-analytic finding that cognitive remediation reliably produces better effects when combined with psychosocial interventions suggesting combination therapies as the way forward.