Cognitive remediation for schizophrenia: current status, biological correlates and predictors of response

Cognitive remediation (CR) is an increasingly studied behavioral intervention for improving illness-linked cognitive deficits in schizophrenia, with considerable promise for improving the disease outcome when offered in concert with other therapies. We present findings from a comprehensive, critical review of the extant literature on CR for schizophrenia. Conclusions from six meta-analyses presented to date are summarized, and existing CR interventions are categorized into three major classes: restorative, strategy-based and hybrid approaches. The crucial elements and empirical support for each class are presented. Studies of predictors of treatment response suggest that attention, motivation and clinician expertise, along with the measures of 'brain reserve', are key features of a positive treatment response. Lastly, findings from studies of neuroimaging indicate that CR is accompanied by structural and functional neural changes in key frontal and temporal brain regions.