Evaluating the impact of Targeted Cognitive Therapy on clinical symptoms in schizophrenia

Schizophrenia (SZ), schizoaffective, and bipolar disorders are severe, disabling, and common psychotic illnesses that affect approximately 2% of the world's population. Neurocognitive impairments affect the vast majority of psychosis patients and are correlated with severity of psychosocial disability. Evidence increasingly suggests that various cognitive therapies (CTs) significantly improve outcomes in psychosis patients, with effect sizes of d[approximately equal to]0.40 vs. antipsychotic medications (APs) alone. Many studies document the safety, acceptability and efficacy of CTs in SZ with benefits often lasting years. In addition to the efficacy of "top-down" CTs, growing evidence suggests that improved neurocognition can also be achieved through "bottom-up" cognitive and sensory training delivered via cost effective computerized cognitive remediation programs. These therapies are being studied across many levels of basic and clinical neuroscience. One distinct form of "bottom-up" CT--termed Targeted Cognitive Training (TCT)--is a "neuroplasticity-based" computerized approach to cognitive remediation. The aim of this paper is to evaluate the effets of TCT on clinical symptoms in patients with schizophrenia