This article has discussed the relationship between cognitive deficits and functional outcome in
schizophrenia. This relationship was noted first by Kraepelin and Bleuler at the beginning of the twentieth century. With the introduction of conventional
neuroleptics, the focus shifted toward the treatment of positive symptoms. In the past few decades,
cognitive dysfunction has been recognized as a fundamental feature of
schizophrenia and has been shown repeatedly to have a negative association with functional outcome [6]. Improvement in cognitive functioning became one of the most important clinical targets in the treatment of
schizophrenia in the 1990s [82]. Main domains of cognition that are disrupted significantly in
schizophrenia include attention, executive function, verbal and visuospatial working memory, and learning and memory. Although conventional
antipsychotics are effective in treating positive symptoms, they lack the ability to improve
cognitive impairment and produce poor functional outcome. Previous research has shown superior efficacy of atypical
antipsychotics on
cognitive impairments in
schizophrenia compared with conventional
antipsychotics. Because the heterogeneity of atypical
antipsychotics in their pharmacologic properties, they have differential profiles of cognitive efficacy in patients with
schizophrenia. Establishing the cognitive profile of each atypical
antipsychotic is an important task. This knowledge can be used to address individual cognitive problems and needs. Because cognitive deficits have been shown to have associations with different aspects of clinical symptoms, limited learning in rehabilitation programs, and functional outcome in
schizophrenia, targeting individual cognitive deficits would lead to greater treatment success in terms of clinical and functional outcome. Although atypical
antipsychotics have some benefit on cognitive function, further efforts to improve cognitive function are required. Attempts at improving cognition in
schizophrenia with specific
cognitive enhancers pharmacologically and psychological
therapies such as cognitive remediation might lead to better functional outcome in patients with
schizophrenia.