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Finding “the Clue” to Effective Treatment

By Daniel B. Martínez, M.D., Member, American Psychiatric Association

Recovery is largely influenced by an individual’s ability to demonstrate improvement in areas of brain function. In 2005, Kopelowicz and his team published an article in Psychology and Medicine showing three areas of frontal lobe brain functioning as being associated with recovery from schizophrenia. The neurocognitive domains found to be influential were: executive function, verbal fluency and verbal working memory.

Performing psychological testing and assuring these areas are improved as much as possible may be important in treatment. Another important finding is the early detection and treatment of psychosis as critical in terms of prognosis, recovery and outcomes. This has been well-known for all disease states. Kopelowicz and his team found that a psycho-educational program for families and patients, La CLAve (the clue), improved health outcomes. This program focused on symptom identification, beliefs on mental illness, seeking professional help and awareness on psychosis. This program raised awareness by using popular cultural icons from the arts, music and videos. With such publicity, it is hopeful that the Latino community will better understand mental health and the avenues for seeking professional help. 

Mental illness has long been stigmatized. First, we must advocate for awareness. Secondly, appropriate funding and access to services must be available. Lastly, research from a multifactorial perspective will lead to the fine tuning of best practices. In summary, findings have shown that Latinos with schizophrenia may do better under the following conditions: 

  • The family adapts to the circumstances of the illness.
  • The relationship with caregivers and providers contain warmth.
  • Psychiatrists and primary care doctors are readily available.
  • Early detection and treatment can limit the duration of the first psychotic episode.
  • The end goal of drug treatment is optimal recovery. 
  • Compliance with drug therapy is in the context of a psycho-educational multifamily group. 
  • Cognitive remediation should be obtained (planning organizing, memory, verbal fluency, etc.).
  • Social skills and problem-solving skills are developed and maintained. 
  • The personal history of the individual living with mental illness is kept free of unhealthy living including drugs, alcohol, unemployment and social isolation.

This article appeared in edición 17 of ¡Avanzamos!, NAMI's Spanish-language newsletter under the title "Research Updates in Schizophrenia" on Oct. 15.


Aguilera Adrian, Lopez Steven R, Breitborde Nicholas J K, Kopelowicz Alex, Zarate Roberto Expressed emotion and sociocultural moderation in the course of schizophrenia. Journal of Abnormal Psychology, 2010; 119(4): 875-85

Breitborde Nicholas J K, Lopez Steven R, Kopelwicz Alex Expressed emotion and health outcomes among Mexican-Americans with schizophrenia and their caregiving relatives. The Journal of Nervous and Mental Disease, 2010; 198(2): 105-9. 

Kopelowicz Alex, Zarate Roberto, Wallace Charles J, Liberman Robert Paul, Lopez Steven R, Mintz Jim The ability of multifamily groups to improve treatment adherence in Mexican Americans with schizophrenia. Archives of General Psychiatry, 2012; 69(3): 265-73.

Lopez Steven R, Lara Ma del Carmen, Kopelwicz Alex, Lolano Susana, Foncerrada Hector, Aguilera Adrian La CLAve to increase psychosis literacy of Spanish-speaking community residents and family caregivers. Journal of Consulting and Clinical Psychology, 2009; 77(4): 763-74.

O’Brien Mary P, Zinberg Jamie L, Bearden Carrie E, Lopez Steven R, Kopleowicz Alex, Daley Melita, Cannon Tyrone D Parent attitudes and parent adolescent interaction in families of youth at risk of psychosis and with recent-onset psychotic symptoms. Early Intervention in Psychiatry, 2008; 2(4): 268-76.

Kopelowicz Alex, Liberman Robert Paul, Zarate Roberto Recent advances in social skills training