# Cognitive Remediation as a Tool for Enhancing Treatment Dimensions of Schizophrenic Symptomatology: A Systematic Review of Randomized Controlled Trials

## TL;DR

This review examines how cognitive remediation affects different symptoms of schizophrenia, finding it most effective for negative symptoms but with mixed results for others.

## Contribution

The paper systematically reviews randomized controlled trials to clarify the effectiveness of cognitive remediation across various symptom dimensions in schizophrenia.

## Key findings

- Cognitive remediation consistently improves negative symptoms of schizophrenia.
- Effects on positive symptoms correlate with baseline severity.
- Results for mood and anxiety symptoms are contradictory across studies.

## Abstract

Background/Objectives: Despite efforts, schizophrenia remains a difficult disease to treat for cognitive, positive, negative, and mood symptoms. In the present review, we explore existing data on the ameliorating effects of neurocognitive rehabilitation and the diverse symptomatology of the disorder. Methods: This systematic review has been registered with PROSPERO (registration number: CRD 420251154674). Following PRISMA guidelines, we conducted a search in PubMed, Scopus, and Science Direct database from inception to 14 July 2025. The methodological quality assessment was made by applying the Joanna Briggs Institute (JBI) critical appraisal tool for systematic reviews. Results: Of the 1001 records screened for eligibility, thirty-five studies were identified for data extraction and synthesis. Of these, seven had a low risk of bias, and seven had a high bias risk. The effects of cognitive remediation on the symptoms of schizophrenia were varied. There are consistently positive effects on negative symptoms, but the findings are mixed regarding other domains of symptomatology. The therapeutic effect on positive psychotic symptoms correlated with the severity of symptoms at baseline. Efficacy for mood and anxiety symptoms is controversial, with a comparable number of studies yielding contradicting results. Conclusions: Cognitive remediation has been shown to represent a significant therapeutic tool for schizophrenia symptoms. The method‘s efficacy seems well-established for negative symptoms, whereas the effects on positive psychotic, mood, and anxiety symptoms, although promising, are currently mixed. More high-quality research targeting patient populations where the symptoms studied are more prominent is needed to clarify the effectiveness of the intervention for distinct dimensions of schizophrenic symptomatology.