title: Executive functions rehabilitation for schizophrenia: a critical systematic review.
abstract: BACKGROUND
  Consistent evidences suggest that poor functional outcomes in schizophrenia are associated with deficits in executive functions (EF). As result cognitive training, remediation and/or rehabilitation (CR) programs have been developed and many theories, methods and approaches have emerged in support of them. This article presents a systematic review of randomized controlled trials (RCT), including EF rehabilitation interventions, with a focus on methodological issues and evidences of EF improvements.
  
  
  METHODS
  Electronic databases (Medline, Web of Science, PsycINFO and Embase) were searched for articles on schizophrenia, EF and cognitive rehabilitation terms. The methodological quality of each article was measured by 5-point JADAD scale.
  
  
  RESULTS
  A total of 184 articles were initially identified, but after exclusion criteria, 30 RCT remained in this review. A proportion of 23% of studies scored higher than 4 points in JADAD scale, 40% scored 3 points, 33% scored 2 points and one study scored only 1 point. The average length of interventions was approximately 80 h distributed around 3.42 h/week.
  
  
  CONCLUSIONS
  The reviewed articles corroborate the literature pointing that CR could be a promising therapeutic option for cognitive deficits in schizophrenia. In general, CR could improve cognitive domains and social adjustment either using computerized or paper-and-pencil programs. Additionally, CR combined with cognitive behavioral therapy and/or group sessions is particularly effective. In this paper, we also speculated and discussed optimal doses of treatment and the differences regarding modalities and approaches.
authors.affiliation: Centre of Studies and Research in Traumatic Stress, Pontifical Catholic University of Rio Grande do Sul, Brazil. brunokluwe@gmail.com
authors.forename: B
authors.initials: B
authors.lastname: Kluwe-Schiavon
authors.forename: B
authors.initials: B
authors.lastname: Sanvicente-Vieira
authors.forename: C H
authors.initials: CH
authors.lastname: Kristensen
authors.forename: R
authors.initials: R
authors.lastname: Grassi-Oliveira
mesh_terms: D056344:Executive Function / Q000502:physiology*; D006801:Humans; D016032:Randomized Controlled Trials as Topic / Q000639:trends; D012559:Schizophrenia / Q000534:rehabilitation*; D012565:Schizophrenic Psychology