There has been increasing interest in intermittent medication as a viable alternative to continuous neuroleptic treatment for chronic schizophrenic patients. Considerations supporting the plausibility of a targeted-medication approach include the fact that long-term medication involves certain risks, and that neither favourable outcome in the long-term nor risk of relapse are necessarily dependent on the continuous administration of neuroleptic drugs. An intermittent-targeted administration strategy was developed by Herz et al (1989) in an attempt to abort relapses at an early stage and to stabilise or to improve the course taken by illness.

We still do not know enough about the aetiology and pathogenesis of schizophrenia, nor are the therapeutic methods generated by our definition of it satisfactory. Therefore, innovative approaches to treating schizophrenic patients, even if they only promise some partial progress, warrant consideration. The purpose of the pilot project ‘Soteria Berne’ is to assess the effectiveness of an open residential programme which has been providing mainly psychotherapy, sociotherapy, and milieu therapy instead of standard pharmacotherapy to about 60 acute schizophrenic patients for more than six years.

Cognitive disorders have long assumed a central position in describing the pathognomonic characteristics of schizophrenia. Kraepelin's (1902) and Bleuler's (1911) uniquely innovative descriptions of attentional dysfunctions and associational loosening in thought processes laid the groundwork for the concept of basic disorder devised by authors who embraced a phenomenological approach to psychopathology in German-speaking countries (Huber, 1983; Janzarik, 1983), and for experimental research endeavours in English-speaking countries to identify a ‘core psychological deficit’ in schizophrenia (Lang & Buss, 1965). Recent research has identified specific information-processing deficits in affected individuals. These include (a) problems with elementary functions such as selective attention towards relevant stimuli and sustained attention over prolonged periods of time (Oltmanns & Neale, 1975; Nuechterlein, 1977); (b) problems with more complex functions such as encoding and recognition of familiar cues, storing information for future retrieval, or drawing deductive or analogous conclusions from available information (Broga & Neufeld, 1981; Brenner, 1983; Nuechterlein & Dawson, 1984b); and (c) problems with executive functions and response selection (Broen & Storms, 1967; Weinberger et al, 1986, 1988).