[Is it possible to improve social functioning of schizophrenia with cognitive rehabilitation?].

Social dysfunction of schizophrenia is observed in many domains including social skills, ability to conduct tasks, attention/durability, volition/motivation, stability of social life, and insight of dysfunction. These dysfunctions have been found to relate to non-social cognitive functioning to some extent. Social skills may have a strong relationship with social cognition. The intervention technique of cognitive functioning of schizophrenia, known as cognitive rehabilitation or cognitive remediation, has its main target as non-social cognition. Cognitive behavior therapy focuses on the contents of the cognitive process, while cognitive rehabilitation focuses on the cognitive process (information process) or thinking skills. Which cognitive functioning should be targeted was revealed as were theoretical models of cognitive rehabilitation, and various intervention techniques and their usefulness. It has been found that some elements of cognitive functioning, such as executive functioning, could be improved in experimental settings in efficacy studies. However, comprehensive rehabilitation including cognitive rehabilitation should be used in order to relieve social dysfunctioning or psychiatric symptoms. Some experts insisted that an individualized program with several steps, along with cognitive abilities, is required to enhance usefulness and effectiveness. Other experts said more complex cognitive functioning profoundly associated with social life should be targeted, rather than elementary cognitive functioning. The conclusions of meta-analyses of randomized controlled trails were not consistent until now, because inclusion criteria of meta-analysis was different. Finally, it was discussed how the theory and techniques of cognitive rehabilitation should be implemented in traditional rehabilitation.