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Cognitive remediation in schizophrenia: proceed ... with caution!

The apparent neglect of neuropsychologic deficits in schizophrenia as the basis for therapeutic intervention, together with only isolated attempts at remediating them, probably reflect the nature of impairments, the functional significance of which is uncertain. A critique of the limitations inherent in the appealing cognitive remediation of the closed-head injured is followed by positive suggestions for the restructuring of cognitive schema that appear to underlie schizophrenic disability in social and vocational functioning.