The neuropsychology of schizophrenia

The ubiquity of neuropsychological impairment in schizophrenia is now irrefutable: it is perhaps the most common symptom apart from lack of insight. There is general agreement about what is impaired and what is preserved. Unifying theories of its root cause are beginning to take shape, but its pathophysiological basis is not. Moreover, exactly where neuropsychological impairment fits into an overall model of schizophrenia is less clear. Whether it represents a risk factor, an intrinsic component, a mediator of genetic liability, a fixed or remediable entity is not known. Its natural history is variable and, despite theoretical perspectives, its treatment with antipsychotic and other drugs is far from impressive. Finally, although the impact of neuropsychological impairment on personal and social function is reasonably well established, the relationship is probably much more complex and less exclusive than has been thought.