Remediation of neuropsychological deficits in psychiatric populations: rationale and methodological considerations

The authors provide a literature review and methodological description of the emerging field of neuropsychiatric rehabilitation. Part I reviews literature that reveals compelling reasons for considering neuropsychological (NP) rehabilitation methods in patients with mental illness. NP deficits are prevalent in these patients and in contrast to psychopathology are predictive of social and occupational dysfunction, the most costly aspect of mental illness in both human and financial terms. NP deficits may explain the relatively poor outcomes from traditional vocational rehabilitation programs and there is evidence that they may be remediable. Part II summarizes methodological considerations required for research in this field. Methods for selecting optimal neuropsychiatric rehabilitation intervention techniques are reviewed and some suggestions are offered along with a brief theoretical discussion concerning their potential neural basis. Finally, design issues are reviewed, some tools for the measurement of outcome are offered, and methods are suggested for controlling for medications and environmental factors.