Schizofrenia e funzioni cognitive: Una revisione critica della letteratura 2. Significato, implicazioni e trattamento dei deficit cognitivi

In the first part of this paper we have reviewed the large body of research showing that multiple deficits in various cognitive functions represent a fairly consistent finding in patients with schizophrenia. The second part of this review focuses on the existing relationship between cognitive impairment and psychosocial functioning: cognitive deficits seem to play a major role on patients' patterns of social and vocational functioning; the implications of these findings for rehabilitation are also discussed, and the more recent attempts to design specific programmes of cognitive rehabilitation are presented. Moreover, the effects of pharmacotherapy with conventional and atypical antipsychotic drugs on cognitive functions are critically analyzed: although some studies have demonstrated that new atypical antipsychotics may have a greater beneficial effect on cognitive functioning as compared to traditional neuroleptics, it remains to be ascertained if these effects are widespread, long lasting and associated with a concomitant improvement in psychosocial functioning. Some data seem to show that the main effect of new atypical antipsychotics may be represented by the absence of impairments in practice effects, which is translated in a better performance on various neuropsychological tests. Overall the effects of new antipsychotic drugs on cognitive functioning and the benefits and limits of cognitive rehabilitation represent important areas to be addressed by future research.