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Background: "Pure" delusional disorders are clinically rare, and the neuropsychology of such disorders is poorly understood. Whereas "deficit" models suggest a cognitive impairment accounting for the incorrigible fixation of false beliefs, cognitive models propose the existence of a characteristic attributional style in patients to stabilise a fragile self., Patients and Methods: The cognitive flexibility and attributional style of 21 patients diagnosed with delusional disorder according to ICD-10 were compared with a group of healthy controls paralleled for age, sex, education, and intelligence., Results: Patients with delusional disorders made more errors and more perseverative errors in the Wisconsin Card Sorting Test compared with controls. However, these differences were only significant in patients with a comorbid depression. In contrast to earlier studies, patients with delusional disorders did not attribute negative events to external or personal causes more often than healthy controls, but partly tended to show a depressive attributional style., Conclusion: Our results do not support either a cognitive deficit in patients with delusional disorders or a characteristic attributional style. In terms of treatment recommendations, a thorough diagnosis of comorbid depressive disorders in patients with delusional disorders is warranted.

Every year, more than half a million people in Germany experience a stroke or a traumatic brain injury. A high percentage of them leave the hospital with neuropsychological deficiencies of attention, memory, speech or perception preventing them from returning to work. The German rehabilitation system is primarily funded by the statutory pension insurance system and is hospital-based, but only very few brain-damaged patients have the opportunity to be treated there. Hospital rehabilitation programmes often integrate neuropsychological trainings whereas neuropsychologically based outpatient programmes do not exist. Therefore two questions are crucial. First, are those separate neuropsychological trainings effective? Second, are positive effects generalized? Studies concerning these questions are reviewed. Not many of them, however, meet the usual requirements for valid intervention research, and their findings are equivocal. Nevertheless, they suggest that neuropsychological rehabilitation should be undertaken more frequently, which would offer a framework for future efficacy research.