Several studies provided evidence that relationship of cognitive impairment with social functioning is stronger than that of psychopathology. In a group of 88 subjects with schizophrenia or schizoaffective disorders we found that verbal memory, executive function and sustained attention indices explained 19.9% of the global disability variance, while negative symptoms explained 4.4% of the variance.

Based on these data our group designed an individualized rehabilitation program including two one-hour sessions of computerized cognitive training and one two-hour session of social skills training per week (Social Skills And Neurocognitive Individualized Training, SSANIT).

In the present study the efficacy of this rehabilitation program was investigated in 58 subjects with chronic schizophrenia or schizoaffective disorder. Patients were recruited in three Mental Health Departments located in the South of Italy and randomly allocated to one of two rehabilitation programs: SSANIT or Usual Rehabilitation Activities (URA) of each department. The active treatment phase lasted 6 months.

At the end of treatment a significant improvement of psychosocial functioning (global psychosocial index, participation in family life and availability to work) was found in the SSANIT but not in the URA group; furthermore a worsening of the negative dimension was observed in the URA, but not in the SSANIT group.

According to our findings, the SSANIT program is more effective than the rehabilitation activities usually implemented in Mental Health Departments (e.g. carpentry and decoupage).