**Acknowledgements**

**3. Conclusions**

54 Psychosis - Biopsychosocial and Relational Perspectives

and with it, its global functionality.

Deficits influence in cognitive domains in schizophrenia disorder is something that severely affect the clinic symptomatology as well as in social, labor and familiar adjustment of this patients, been something not to be ignored. Even so, so few familiar intervention programs are focus in explain and give intervention strategies to this deficits from home daily life. To these problems it might be added a big possibility of finding a lower cognitive deficit in some family members without pathology, with what it might be necessary to intervene face to them having a more realistic and adjusted perception of their children illness. With that we wish to avoid that cognitive disrepair

Considering all the presented data about cognitive endophenotypes, it might be understand that a genetic component exits in the pathology, but we cannot erase environmental factors influence. It is not impossible to add changes in the psychosocial patient environment with whom it might improve, not only symptomatology, but it social and labor adjustment. In the other hand, it is already been commented that family might affect negatively in both patient types, frequently because a high expressed emotion [133] affecting patient self – perception

In this way, it was expected to find that, in general, familiar interactions to resolve problems might seem to be less constructive and more problematic when the family member suffers schizophrenia disorder versus others disorders. Salinger *et al*. [149] recently studied those interactions between parents and their teenage affected children (or at high risk) of psychosis and bipolar disorder. After control variables in the parents as: sex, age, functionality, education. They observed that mothers of psychotic teenagers got a significantly more conflictive and less constructive communication than mothers of bipolar teenagers. The obvious conclusion is that, given that the family environment among adolescents seeking help may be more challenging for families with adolescents with psychosis than in other serious pathologies. These families need a more intensive and focused communication training than would be required for families with adolescents with high-risk for bipolarity or other mood disorders. In general, research highlights the importance of psychosocial and family factors. These interventions become more important if we take into account works such as Engh *et al.* [20] where he pointed out that an adequate awareness of deficits is related to a good adherence to treatment, but also to a bad perception of self-confidence and self-efficacy. And on the other hand, we cannot ignore that all these aspects will be terribly influenced by the more than frequent stigmatization suffered by these patients and the disastrous consequences of it in their personal perception [139–143]. As can be observed, the intervention of cognitive aspects, although important, must go beyond and in order to ensure their effectiveness, it should be encompassed in other fields closely linked to family interactions according to achieve a greater perception of the effectiveness of the subject, which can lead to greater functional participation as it would be through the promotion of self-esteem, absence of continuous

might be seem as a personal product, an attitude lack or even a defiance sign [19].

criticism, skill training, daily contact and attitudes of acceptance and coping.

The author wishes to thank Laura Santamaría for her disinterested collaboration in this review.
